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Discussion

Earning potential

I was shadowing a CRNA the other day an he asked me why did I want to become one when ACNP's can make just as much. I told him anesthesia interests me a lot and all the reasons that come with being CRNA. However, his statement surprised me because I had no idea NP's could make $175k. He said he knew plenty making 200k with enough OT and call. Most worked ED's where they could perform a lot procedures am bill for them he said.

I was wondering how valid his statements were regarding earning potential for NP's. is it common if enough time is invested each week?

I'm in the Memphis area to give you an idea of region

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I was offered $150K + profit sharing as a surgical NP with on call, but I turned it down. I want to see what it feels like to have only one job, and only work 40 hours a week. I've never done that as a nurse, except when I was in grad school.

I have not heard of anyone making that kind of money, but I supposed anything is possible. The highest salary I'm aware of is someone working inpatient and outpatient psych who earns $100-110K salary.

Yes the figure that he quoted you sounds high for a NP, but definitely doable for CRNAs. CRNAs, from my research, enter around $130-150k. They are definitely higher paid than NPs and yes, I assume, if NPs want to work their tail off with call and OT, this figure is possible. Many, however, I would presume like to have a life out of work.

Now Im not certain but I thought CRNA's make more money just in general. With Nps it depends where and what you practice. I would check out the local area and see what the going rate is for NP v CRNA without OT or taking call.

You would be hard pressed to make that as an ACNP in your area.

  • Author

Yea 90% of research has turned up a mean average of 98k with a few outliers >110k,

It sounds as if he is talking about fee for service. You bill for your own procedures in the ER. Some places do this if for instance, you have a group of NPs that contract to cover the ER. It is very doable in that scenario.

Another is covering ER in shifts. If you do 12 or 24 hour shifts at 75/hr, which is what I get for ER coverage. It can add up.

As far as anesthesia, 135-140 is very low. The national average (last time I looked) was 180k. Higher pay in south and west states.

  • Author

Only problem is most southern states aren't opt-out states yet. Which brings me to another question, can an independent CRNA open their own anesthesia practice?

Opt out has absolutely nothing to do with practice. Non opt out states only means that FOR BILLING MEDICARE, the crna is considered to be under the general supervision of the surgeon. It has nothing to do with state practice law. It does not mean that the surgeon is responsible or tells the CRNA what to do. You can have independent practice in a non opt out state.

The below explains it better than I can.

Yes, many CRNAs have their own practice and even own anesthesia practices.

Nothing in the Governor’s decision changes the way in which CRNAs currently practice in Colorado. It does not suddenly allow CRNAs to practice independently where the law did not already allow it. The ONLY thing that has changed is that CRNAs can bill Medicare for anesthetics they deliver when not supervised by a physician. Their lawful ability to provide independent anesthesia services already exists and has for years. The citizens of Colorado need only look amongst their neighbors and friends for all of the dead and maimed patients treated by CRNAs to realize an intentional and baseless attempt to frighten the elderly when they see it. Rein continues:

Only problem is most southern states aren't opt-out states yet. Which brings me to another question, can an independent CRNA open their own anesthesia practice?
  • Author

Thanks for the information. I'd be willing to be crna's that are partners of successful anesthesia groups are making double if not more than regular salaried ones. The idea a nurse can make that much money is staggering.

I am a FNP in family practice and I work .8 and will earn somewhere between 140 and 155K this year, depending on bonuses. I think I would make over 175K if I worked FT. I am an independently practicing NP and part owner of the practice.

I don't know any CRNAs and have no idea how much money they earn here, but I assume they earn more than I do. It is exceedingly rare to see an MDA except in the university system. We bought our house from a MDA who had to move out of state to find a job after practicing for over 20 years; I felt really bad for the guy. One of my patients is a MDA who is retired against his will just because he can't find work. He too had 15ish years of experience and was laid off in favor of CRNAs. He is working outside of his field reviewing for texts and journals, but can't get a job passing gas and complains bitterly about CRNAs (but comes to see a NP as his PCP, lol). CRNAs definitely dominate most of the state. My dentist has a CRNA in the office. There are chiropractors in town hiring them (which I think ought to be criminal, but that is another discussion), ophthalmology offices, plastics, and on and on. They are ubiquitous and if that is what interests you I am sure you will not be lacking for work opportunities. The question is if the market is going to get supersaturated to sustain the current high salary. I can't answer that. I am sure the compensation will always be generous, but I don't know if it will stay quarter of a million dollars territory. So the moral of the story is, don't do it just for money, because the super huge dollars may not always be there and there is very nice money to be made as a NP in the right practice environments.

Do what interests you and forget the money. You will earn plenty of money either way, just make sure you are engaged and challenged.

  • Author

What engages me the most-in theory,obviously- is the super focused area of work. I would prefer knowing a lot about one thing, then a little about everything. Personally I think, with the way I function and think, I would put less people at harm this way. It seems too easy to miss something in the practitioner world. Are there sub specialties in NP that one can go into that would be a lot more focused? Eg. Cards or something of the sort? Something I can really learn A LOT about and be REALLY good at. Be someone to get referred to?

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