Chiros depending on NPs for their new practice model: watch out!

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Okay, so now we have chiropractors veiling themselves by creating new professional corporations that do not identify themselves as chiropractors but as medical business owners. They call their clinics integrative medical practices and hire (or try to hire) a NP to bill all services and perform everything but manipulations. So if I read this clearly, we NPs are their oxygen to survive financially yet the pay is roughly 50$ an hour. What a joke. Any NP who even considers this position needs to get at least 100$ an hour plus a medical director fee of at least 1000$ (especially if you work in an unrestrictive state). Better yet, NPs should set up their own practices and perform the same or better service and keep the profits.

Just really frustrated seeing these nps work for peanuts and being taken advantage of. Pass the word around.

Ye of little faith. The word will spread

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Read the Art of the Deal by Donald Trump. It's an easy read, can upload it on iBooks and it gives you a sense of what negotiation is all about. It's about knowing your market, knowing your self worth, knowing your value. If your an NP you are the oxygen

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Specializes in Family Nurse Practitioner.
Take business classes at a local community college. I've been doing that for the past year in preparation for an MBA program and it helps you learn how businesses work and will help you understand healthcare as a business and your worth.

Interesting decent idea, I wonder if it wouldn't be cheaper and quicker to find seminars? Cococure, I'd push your school to line up a speaker to give your class some pointers. The most important thing I can add is to know 1099 vs W2, this alone can cost you a huge percentage of your income if you don't. Unfortunately I found my professors to be as lacking as my peers in this area. My parents were big into business so I had a bit of an advantage as it was dinner table conversation my whole life. I have heard decent things about Carolyn Buppert's stuff:

Carolyn Buppert, Law Office | Specialist in legal and reimbursment issues for nurse practioners and physicians

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Very interesting idea! I do have one friend and her school offered classes on resume, interviewing and business model type stuff when it was time negotiation she knew exactly what questions to ask during an interview. Needless to say she had a very strong offer in the end. As I get to know the school that would be a good suggestion to make. I was also thinking of joining a local NP organization, I know I am only a student but I think it would be a great way to network with local NP's

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Specializes in Pediatric Critical Care.

Does anyone have any advice to offer or resources to point to that will help new grad NPs learn how to be savvy businesspeople and good negotiators?

Do any newish NPs feel that their programs prepared them for this aspect of their careers?

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Carolyn Buppert RN, JD has been providing expert Legal and Professional Issues for Nurses advice at Medscape Nurses for several years.

Some of Carolyn's articles I've read that are helpful to NP's:

Buppert is an excellent resource for NPs who plan to start their own business. I just bought the 5th edition of Nurse Practitioner's Business Practice and Legal Guide. Small areas of it need to be updated...(i.e. encouraging practitioners to advertise in the Yellow Pages). But overall it contains all the important stuff that one needs to know in order to run a business as an NP. It is an expensive book, but worth it. In the past she has done seminars within NPACE conferences for people who are interested in starting their own business. She is excellent. I don't do the NPACE conferences anymore though because they've gotten way too expensive now and they are now charging extra to attend the training sessions within the conference. But, I recommend the book, which also has a section on how to negotiate employment contracts.

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Does anyone have any advice to offer or resources to point to that will help new grad NPs learn how to be savvy businesspeople and good negotiators?

Do any newish NPs feel that their programs prepared them for this aspect of their careers?

See my comment above. My NP program gave us a non-clinical course at the end that attempted to provide some of this information. But it wasn't enough. You have to network, ask questions, and take your information from multiple and dependable sources.

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Specializes in ICU, Telemetry, Cardiac/Renal, Ortho,FNP.

I'm glad somebody started a thread on this. However, I guess I should clarify what is happening in the chiropractic industry. In a nutshell, they are wanting to start multidisciplinary practices that in the past had to have a medical doctor appointed as medical director. They had to pay the MD/DO real money to get PI/WC and in house referrals. Only problem is they wanted to control the physician, which by default, is both usually illegal and unethical. So a little diversion is to house the mid-level and just pay the physician who shows up 1x a month to check records, the usual. Physicians love it b/c that's, depending on the state, $1K-10K passive income a month. So for the most part you are not working under the D.C. but let's be real..yes, you are and that's still illegal and unethical. A cross between is where I am at which is both a D.C. who went back to school and got their NP. Now, for me, I quit chiropractic and hit the hospital floor and worked/learned everything from the ground up. I, personally, resolved to the standard of care that I can't practice as an advanced practice registered nurse if I've never practiced as a registered nurse! Makes sense but so many other D.C./NP's have a different take and they are entitled to it. They are usually excellent clinicians and want the background and licensure to be able to practice medicine (albeit through nursing) with minimal physician oversight. In effect, they are still practicing chiropractic while prescribing. This is such a gray area that nobody knows exactly what to do with it right now so it exists in its rare form. All this to say that it generally helps the patient to get physical and prescriptive therapy (which is what I thought D.O.'s were about???) in one place with one provider. In other words it helps get PI/WC cases b/c you have more to offer and have more legitimacy with atty's and insurance co's.

My experience? I didn't see substandard wages being offered. I got offered $95K to start with benefits. I've been a chiropractor and I know the promises don't match the delivery. I just could not trust the practice to maintain the revenue needed to meet my expense. While I think I could have helped their practices tremendously I think a lot of my nursing skills would be wasted in a limited experience for the patient. So I resolved to stay in either pain management or ortho, where a lot of my experience is, as an NP only. So an NP working "for" a D.C....my advice is NO. If you can find one that's had a great practice for a few decades and will work "with" you I think you could be happy if you have a good financial arrangement. Rare but doable. However, I think this arrangement is much, much more common with just finding a local physician to work with also so why bother?

Just for the record I've seen NP job ads for cardiology NP's paying just $37/hr. I have no idea if they ever found anyone...I hope not. So I don't think D.C.'s are just out to victimize NP's but I wouldn't just jump at an offer...it's just that "AN OFFER", not a promise/contract. I would NEVER work for a new DC practice. I did take a job with a new physician owned practice but their chance of success is much greater.

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I'd love to chat with her

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What state do you practice in?

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