Confession, I'm not an NP, I'm a DO and in the last year of a Family Medicine residency but I have been working on opening my own practice but had a few questions I was hoping to get some information on in regards to hiring a NP.
1. What kind of salary do you expect?
I've seen ranges from $65K - $150K. Both seem like extremes to me and I'm contemplating the $105K mark with some fluctuation based on experience.
2. What are you thoughts on new hire vs experienced?
To be honest, I'm a little concerned with the quality of some of the NP students that have been rotating through here at work. I have family who are NP's but they were nurses for 10-15 years before going back to school. These same family members have mentioned that some of the newer NP's are less prepared and some have come from 18 month BSN to programs followed by direct entry dnp programs and don't have much patient contact hours. I even overheard a 3rd year med student last year explain some pretty basic pathophys to an NP student and wondered if this might be a problem or commonality in education? I just have more experience with PA's but have been told by another doctor to hire NP's instead. Obviously I would interview each candidate, but am looking for some honest feedback about certain institutions that I should be wary of.
3. Continued Education (In addition to Continued education hours)
Based on the previous question, an older doctor I talked to runs a weekly morning lecture where he provides breakfast and uses lectures he gives at a local medical school to impart the knowledge deficit he feels exists to the providers at his own practice. I know there exists a "Turf War" in Physician vs NP/PA, but I honestly don't care about it and don't want to hire anyone who does. I am concerned though with providing appropriate care and avoiding malpractice suits, and the above anecdotal story about the NP student and 3rd med student does worry me a bit. I'm sure that's an anomaly, but my aunt (DNP) also told me about a recent hire at her work (New Grad DNP) who prescribed a long prednisone course to an elderly immunocompromised female patient, but my aunt caught it. I don't want to be the a-hole patronizing doctor that thinks he knows everything (because I don't, just finishing residency), but I also like the idea of a simple 20-30 minute keep current refresher. Thoughts on this? Would it be helpful? Or just kinda piss you off eventually?
4. Benefits.
I know that lots of NP's (really all healthcare workers) put a lot of things on hold while in school and working (like starting a family). I'm originally from Canada, so I think that hey, if you carry a baby for 9 months, and then go through labor, you might need some time off. I've worked into my business model a plan to pay for 3 months time off @ 50% wages to any employee who has a baby AFTER being employed for 1 year. This would be subject to some conditions, and would be determined on a case-by-case basis depending on circumstances (ie. birth defects, difficult labor, etc.). My goal is to attract the best NP's, treat them well and have them stay on. My question is would you prefer the above scenario with a smaller annual bonus, or just a larger annual bonus? What other benefits (apart from the normally expected) would make a difference?
Sorry this was a long post, appreciate any and all thoughts and contributions.
The Inception effect? A turf war within a turf war, within another turf war. Leo would be proud.
Prior RN experience has been studied...it doesn't matter. Get off your Seabiscuit, he has been dead for a long time.
Verdict is still out. Patient outcomes have never been studied. Only ability to pass boards. There's always room for more research and neither sides opinions have been validated one way or another.
NP's bill at 85%. So how much would you pay your MD's and would you pay NP's 85% of a physician's salary?
My problem with doctors asking these questions, is many of you complain about NP's being able to practice autonomously (and other nasty things), but I'm seeing many family doctors making big bucks off paying young and inexperienced NP's, RN salaries.
Opening clinics and hiring a bunch of NP's has become big business for the same physicians, who don't think NP's are smart enough to provide care and dangerous for NP's to practice medicine. NP's will start opening their own practices if MD's keep paying them pennies on the dollar. In NY, a NP can practice autonomously after 3600 hrs of practice. I know a doctor in NYC, who is opening clinics everywhere and leaving NP's to run his clinics by themselves (some of them are recent graduates). NP's in NYC can bill medicaid and medicare 100%, but are only making $110,000 on average. Do you think that's fair?
No such thing as an excellent new MD and even they themselves would tell you that they know nothing. So I don't know how there can be excellent new grad NP's.
I appreciate all of the responses thus far, along with the tips and advice! My goal in asking here was to get as much information from those that I would be working with. Having a fun, productive, and positive work environment is important to me and having the right providers is key to that so I do appreciate all the input that contributes to creating an environment that fosters creating this type of practice where all providers will feel valued!
Also, THANKS A MILLION to all the hardworking RN's and NP's who help out the clueless 3rd and 4th year med students! Heaven knows I wouldn't be here if it wasn't for their help! All you NP's rock!
NP's bill at 85%. So how much would you pay your MD's and would you pay NP's 85% of a physician's salary?
My problem with doctors asking these questions, is many of you complain about NP's being able to practice autonomously (and other nasty things), but I'm seeing many family doctors making big bucks off paying young and inexperienced NP's, RN salaries.
Opening clinics and hiring a bunch of NP's has become big business for the same physicians, who don't think NP's are smart enough to provide care and dangerous for NP's to practice medicine. NP's will start opening their own practices if MD's keep paying them pennies on the dollar. In NY, a NP can practice autonomously after 3600 hrs of practice. I know a doctor in NYC, who is opening clinics everywhere and leaving NP's to run his clinics by themselves (some of them are recent graduates). NP's in NYC can bill medicaid and medicare 100%, but are only making $110,000 on average. Do you think that's fair?
Well shame on the NPs. They are not victims, they are volunteers. This is a prime example of us being our own worst enemy. There would be no market for low paid NPs if there weren't NPs willing to accept it. They are ruining the market for us all.
If you're opening your own practice, you'll likely have a ramp up period where business, and hence your schedule, is a bit slower. Depending on your area, it could take a while to ramp up to a full patient panel. Why not contact one of the nursing schools in the area and ask to precept a final semester student? You can essentially use it as a semester-long interview. You may be able to do this for a few semesters before your practice is big enough to support two providers.
DannyBoy8, RN
219 Posts
The Inception effect? A turf war within a turf war, within another turf war. Leo would be proud.
Prior RN experience has been studied...it doesn't matter. Get off your Seabiscuit, he has been dead for a long time.