FNPs don't let me down!!! Where's the Money?

Goldenfox · Mar 19, 2017

I've read the salary posts, almost to my dismay.

Another reason for the low pay is that some of us have done it to ourselves. Some of us take the low pay, and we even justify it. I have worked with many physicians over the years and I have never heard even one of them try to rationalize accepting low pay by selling themselves and their profession short---because they are so grateful for mommy hours, or because they believe that taking care of patients is much more important than taking care of their own families and themselves. If WE don't believe that we're worth more then why would any employer?

True that we are not physicians and don't have the same training that physicians do, but we have enough training to diagnose people and write prescriptions---and that's all that these doctors, agencies, and corporate health care entities who employ us really care about. They use us to save themselves a ton of money, and they make bank no matter how much they are paying us. Lowballing is simply their way to get more. And they lowball because they know that they will always find a nurse practitioner who's desperate enough to take their ridiculous offers even without any effort at all to negotiate. I see it all the time.

Health care in this country is once again about to go through dramatic changes, and I believe that some of these changes will create more opportunities for NPs. Its up to us to become more politically astute and use our diplomas and prescription pads to our advantage just as the docs do. If you want more, ask for it.

MierKat · Mar 19, 2017

Business adage: If you don't ask, you don't get.

Goatie · Mar 31, 2017

I believe hospitalist NPs and anesthetists make the most bucks. Psyc NP's too, coz not everyone has the constitution for mental health problems/illnesses. If you work in snf's, this is a high paying gig, because pts can be so sick in the snfs (just like acute and sub-acute type problems because the HMO's wont transfer them). When accepting a job, look at all the benefits including 401K. Some companies are extremely generous with their matching (Ive had a job that did 100% matching if you put in 6%). Another company paid 50% matching of whatever you put in after 3%. I wouldn't go for under $60/hour now but I'm an experienced dinosaur.

Goldenfox · Apr 1, 2017

Another consideration is self-employment. Its logical to imagine that if one can put together a good business plan and can generate the seed funding to start up a small operation, its not an entirely ridiculous idea to start one's own business and keep all of the money for oneself instead of limiting one's career to helping a doctor to get richer. Even in states where NPs are allowed to start up their own businesses most NPs still choose to try to get a job working for someone else---even if it means accepting lowball employment offers.

One of my colleagues who I graduated from NP school with owns a home health business as a provider who does old-fashioned house calls mostly on chronically ill and old people who aren't sick enough to be in hospitals or nursing homes but who don't have the wherewithall to come in for office visits. She has a part-time NP and a small team of per-diem home health RNs working for her. Her overhead costs are minimal because her office is a room in her house. Financially, she is doing exceptionally well and the business is growing.

I was also recently at a conference where I met an NP who owns two very successful primary care clinics up in the northeast. Because I've been years in the process of putting together the plan to start my own business I have been networking with quite a few of these NPs and absorbing their ideas.

Of course, not everyone has what it takes or can bother with the responsibilities of running a business, but for those who do and who do it right it can be quite lucrative.

kegreat · Apr 25, 2017

This is ultimately where i would like to end up after getting some experience!