Why are there so many SHADY clinics hiring? *New grad Vent*

[Trilldayz,RN BSN]

Hey guys, like many new grad FNPs out there, I have been looking for a job for quite some time now. Maybe it's just me being frustrated, but it seems like so quite a few of the smaller clinics that are hiring are really shady. Some examples are:

1) a lot of these clinics geared to the Spanish speaking population or 'Clinicas' are employing foreign medical doctors (who have not gotten American licenses to work under the licenses of NPs). I (personally) don't have a problem with foreign doctors. What I DO have a problem with is if they try to use MY name/credentials to order/prescribe things.

2) plenty of clinics that strongly encourage the NPs to trump up patient's visits to boost revenue.

3) Doctors who have had their licenses REVOKED or SUSPENDED still recruiting NPs to work for them.

4) Doctors who basically lure NPs in and conveniently hide the fact that their clinic is really a pain pill mill.

5) Doctors who want to hire NPs for $60-75k (NO benefits), but want them working 8 to 11 hour days, 6 days a week. (I am in Houston where we were told to not settle for less than 90k for full time work)

I am getting to the point, to where I am ready to just stop looking for now. I was promised a job at a smaller clinic and the day before I was set to start, I was told that the clinic is having financial issues and I will need to "wait" before I can start. They couldn't even tell me how long that "wait" would be. Uh, NO. How unprofessional. Thank goodness I still have my agency RN job, and not something I had to give my 2 weeks notice. But I can't lie, I'm still pretty pissed about it, especially since I've started the job hunt all over again, only to see these horrible options.

Why are some doctors/clinic owners so unethical, greedy, untrustworthy, and use the NP for their schemes? And with so many new NPs who just want the experience and are having so much bad luck in looking for a job, I hate that we are kind of stuck between waiting FOREVER for legitimate work, or just risking our licenses at a shady place for that 1 to 2 years of needed experience.

Please help, if you have any words of encouragement, I really REALLY need it right now.

***vent over***

[travelNP]

Haha sounds like Miami.

[KatieMI, BSN, MSN, RN]

For the same reasons that some MD residency programs selectively market to foreign medical grads, who then can be used for whatever from overcharging Medicaid to tampering with prescriptions to involving females to activities usually called "having some fun while on call in hospital". They think they are dealing with people who are either desperate, stupid or afraid, or all that put together.

I know it is more difficult to say than to do, but if every single NP, or an RN or every one else, for that matter, will just report to authorities every single suspicious activity, the things will start to move in the right direction sooner or a bit later. We will not hesitate to report a child covered with bruises in ER, even if eventually it will came out that the child is very well cared for but in serious figure skating training and so bruises caused by falling on ice. Why, then, should a person not employed in a "pain clinic" opened a month ago in the nearby strip mall hesitate to call authorities and ask to investigate?

[Goldenfox]

Haha sounds like Miami. Message me if you are interested in doing a temporary travel position in McAllen, TX for a few months to gain experience. They would provide lodging and travel. It is with a federal health site so you know it is trustworthy lol

You're right. It does sound a lot like south Florida. Message me please about the McAllen gig. I have a friend in Florida who's looking and interested in locum in the South. Thanks.

[Goldenfox]

Hey guys, like many new grad FNPs out there, I have been looking for a job for quite some time now. Maybe it's just me being frustrated, but it seems like so quite a few of the smaller clinics that are hiring are really shady....

I am getting to the point, to where I am ready to just stop looking for now.

If you stop looking then you further reduce your chances of finding something that suits you. It has become the norm now to expect that it will take a while before most new grads find that first job, and even when they do, it sometimes sucks---but for only that first year. After you gain some experience you will find that you have more options to move around and to earn better pay. You have to chill, and take this all in stride. It's just the way the job market it is overall, it's not you. Just keep working as an RN while you actively look around. If you aren't having any success on your own then try a couple agencies. Or, you could try some of the hospital systems. Many of them are recruiting NPs for acute care positions. Some might accept new grads---won't hurt to call some of them and ask.

As you conduct your search you should consider setting up a system that helps you to identify and exclude these types of shady places that you've been running into. If you see an ad for a position with a private physician practice, look him/her up in the state database to see if there are issues with his/her license before applying for the job. And for smaller practices, look them up in the state database to see how long they've been in business. If the place is new and appears to be a dive joint in a sleazy part of town then don't bother. Retail clinics...pursue only as a last resort. Same thing with pain management places---AVOID. And as far as FMGs go, I would not accept any job where they are ordering things under my name and license.

Why are some doctors/clinic owners so unethical, greedy, untrustworthy, and use the NP for their schemes?

Because they can. Exploitation and profiteering are nothing new for many of them, but it hits new grad NPs in ways unlike anything that new grad physicians ever see.

[turnforthenurse, MSN, NP]

Trilldayz, what program did you graduate from?

[smartypants31us]

I almost thought you were speaking about Miami. I was lured into a clinic that told me I would be paid 45/hr. Full time position in this old run down clinic in the inner city. I felt so uncomfortable about the major jump in the beginning ( I should have listen to my gut!) but me being so determined to work as a NP didn't realize the hole I dig for myself. Everything was done so ghetto; they basically got into a van and ran around all of Miami looking for patients and anyone who was willing to get in the van and receive care at the clinic. I really wondered how they billed. It was myself and another NP which I found out I were to replaced. They wanted to fire her and keep me on but didn't tell her because they wanted me to receive some type of training. No supplies what so ever. I completed accu-checks and had no sharp boxes present. I even had a patient with a fractured foot and I didn't even have a ace bandage or anything. In the end I left because I wasn't paid and went berserk on the owner for hiding and giving me bounce checks. I received one full check and after that the clinic owner went missing. Bounce checks everywhere. I was so embarrassed to go to the bank praying they wouldn't say "excuse me ma'am I have to get a supervisor". It was ridiculous and my RN job was already taken for. Its clinics everywhere now and what's really scary is no one has an license! My advice, don't leave your current steady jobs unless its a great deal and its in writing. It isn't worth the pain, suffering and embarrassment I had to go though. I still haven't found a NP job yet.

[Trilldayz,RN BSN]

Trilldayz, what program did you graduate from?

PVAMU in the Texas Medical Center. Good school!

[Trilldayz,RN BSN]

If you stop looking then you further reduce your chances of finding something that suits you. It has become the norm now to expect that it will take a while before most new grads find that first job, and even when they do, it sometimes sucks---but for only that first year. After you gain some experience you will find that you have more options to move around and to earn better pay. You have to chill, and take this all in stride. It's just the way the job market it is overall, it's not you. Just keep working as an RN while you actively look around. If you aren't having any success on your own then try a couple agencies. Or, you could try some of the hospital systems. Many of them are recruiting NPs for acute care positions. Some might accept new grads---won't hurt to call some of them and ask.

As you conduct your search you should consider setting up a system that helps you to identify and exclude these types of shady places that you've been running into. If you see an ad for a position with a private physician practice, look him/her up in the state database to see if there are issues with his/her license before applying for the job. And for smaller practices, look them up in the state database to see how long they've been in business. If the place is new and appears to be a dive joint in a sleazy part of town then don't bother. Retail clinics...pursue only as a last resort. Same thing with pain management places---AVOID. And as far as FMGs go, I would not accept any job where they are ordering things under my name and license.

Because they can. Exploitation and profiteering are nothing new for many of them, but it hits new grad NPs in ways unlike anything that new grad physicians ever see.

THANK YOU for your words of advice! I have agencies attempting to help me at the moment. I just got an email today for a job with an endocrinologist. I was excited until I saw her patient reviews :-(

She has all bad ratings from patients. some said she was kinda rude. I will still go to the interview though, but I'm ,obviously, nervous about that. Her license was clean though. What do you think? And another agency I'm with will send my resume to a FP clinic that's about 40 min away. I HOPE I get a call back for a interview.

[Trilldayz,RN BSN]

Please PM me for info!

[Trilldayz,RN BSN]

I almost thought you were speaking about Miami. I was lured into a clinic that told me I would be paid 45/hr. Full time position in this old run down clinic in the inner city. I felt so uncomfortable about the major jump in the beginning ( I should have listen to my gut!) but me being so determined to work as a NP didn't realize the hole I dig for myself. Everything was done so ghetto; they basically got into a van and ran around all of Miami looking for patients and anyone who was willing to get in the van and receive care at the clinic. I really wondered how they billed. It was myself and another NP which I found out I were to replaced. They wanted to fire her and keep me on but didn't tell her because they wanted me to receive some type of training. No supplies what so ever. I completed accu-checks and had no sharp boxes present. I even had a patient with a fractured foot and I didn't even have a ace bandage or anything. In the end I left because I wasn't paid and went berserk on the owner for hiding and giving me bounce checks. I received one full check and after that the clinic owner went missing. Bounce checks everywhere. I was so embarrassed to go to the bank praying they wouldn't say "excuse me ma'am I have to get a supervisor". It was ridiculous and my RN job was already taken for. Its clinics everywhere now and what's really scary is no one has an license! My advice, don't leave your current steady jobs unless its a great deal and its in writing. It isn't worth the pain, suffering and embarrassment I had to go though. I still haven't found a NP job yet.

You feel my pain!!! (((hugs))) It isn't just Miami, believe me! Good luck to you!

[Goldenfox]

I almost thought you were speaking about Miami. I was lured into a clinic that told me I would be paid 45/hr. Full time position in this old run down clinic in the inner city. I felt so uncomfortable about the major jump in the beginning ( I should have listen to my gut!) but me being so determined to work as a NP didn't realize the hole I dig for myself. Everything was done so ghetto; they basically got into a van and ran around all of Miami looking for patients and anyone who was willing to get in the van and receive care at the clinic. I really wondered how they billed. It was myself and another NP which I found out I were to replaced. They wanted to fire her and keep me on but didn't tell her because they wanted me to receive some type of training. No supplies what so ever. I completed accu-checks and had no sharp boxes present. I even had a patient with a fractured foot and I didn't even have a ace bandage or anything. In the end I left because I wasn't paid and went berserk on the owner for hiding and giving me bounce checks. I received one full check and after that the clinic owner went missing. Bounce checks everywhere. I was so embarrassed to go to the bank praying they wouldn't say "excuse me ma'am I have to get a supervisor". It was ridiculous and my RN job was already taken for. Its clinics everywhere now and what's really scary is no one has an license! My advice, don't leave your current steady jobs unless its a great deal and its in writing. It isn't worth the pain, suffering and embarrassment I had to go though. I still haven't found a NP job yet.

I believe every word. I know the Miami scene well. Number one place in the country for Medicaid fraud and grifters. At least once every couple years the feds make multiple busts there and take away doctors, nurses, and clinic staff in handcuffs for ripping off millions from Medicaid. Most of them keep getting away because they are smart enough to know not to keep the gig going for too long in one location. By the time the feds begin their clampdown the clinics close down and reopen in a different location under a different name with the same group of fraudsters. Many of the clinics there are unlicensed, and many of the 'doctors', 'nurses', 'dentists', etc. don't have a license either. These are the kind of people you can end up working for when you apply for an NP job there. It's scary what goes on there!