New grad NP job offer- questions

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Hi everyone!

I'm located in MA and just finished up a FNP program and will be graduating this month. I have started to applying to jobs and had 1 interview that resulted in a job offer this week, and as selfish as this may sound for a new grad (since I know jobs are hard to come by), I'm not sure if it's an offer I should take.

It would be a full-time position in internal medicine 8-5 M-F, no call, no weekend hours. It's a brand new practice (not seeing patients yet), and will be the physician and owner of the practice and myself. The physician has worked with NPs in the hospital setting but it seems like he has little knowledge of the certification/credentialing process when on-boarding a new grad NP since he wanted me to start ASAP, even though I have yet to take my exam. So, that could be an issue going forward.

Salary is 100K, benefits eh (two weeks vacation and sick time) and when I kept asking questions about an orientation or back-up support, especially during the first year, he was supportive but vague, so I'm unsure about that as well.

I have been mulling over since last week and need to call back tomorrow, but I'm really stuck on what to do. Ideally, I'd like to keep searching since it doesn't sound like an ideal new grad environment but I know how difficult getting that first job can be, so I don't want to turn down the only job offer (or interview for that matter) that I've gotten so far.

Any advice would be greatly appreciated! Thank you!

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Specializes in Family Medicine, Tele/Cardiac, Camp.

Hmm. Tricky. I did my program in Boston and as hard as it was for me to find a position in the city (I ended up having to move for my 1st job), I don't think I would have accepted a position with a new practice that wasn't also heavy on the orientation/support.

I don't know what your prior experience is and/or your APRN clinical strengths, but for me personally I would have looked elsewhere had I been offered a similar position.

Best of luck!

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Thank you! I agree. I did my program in Boston as well and am committed to living here for a few years at least (just bought a home and husband's job is here) and I know how saturated the market is for new grad NPs. I imagine I may have a hard time getting another offer so I was stuck on this one, but I'm leaning towards no. I am currently working as an RN and did have strong clinicals but feel I would need a more structured learning environment the first few months than a brand new practice can offer with one provider, who also stated he wouldn't be there everyday.

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Specializes in Internal Medicine.

I'll argue from the opposite perspective and say it will likely be a good learning experience. As a new practice it likely won't be very heavy on patient load to start, and your sponsoring physician will be able to give you attention, versus walking into an established practice that is constantly slammed. PLUS all the patients you will be seeing are going to be new to the practice so you can develop strong relationships from the start. A lot of times its hard joining an established practice when patients are used to seeing the same provider, and they may not want to see you. It's dumb, but that's the reality of the game.

If I would do anything with your contract though, is make sure you don't get locked into the same salary for multiple years, especially as the practice grows. Also try and get more time off or get something in there that says after the first year you get 3 weeks.

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I kind of like what Riburn has alluded to here. I agree 100%. There will be a ramp up and this will effectively help you establish a panel of patients rather than come in and take over someone else. Coming in at this time may afford you some flexibility in shaping policy at the practice itself as needs arise that need to be addressed.

I also agree with negotiation in your contract. It's certainly okay to haggle with the terms of employment. If they offered you the job, then you obviously have what they are looking for, so now make sure they know you have conditions that need to be met. They are doctors, so they know all about this, and shouldn't object to it.

Things to consider asking for in your contract include:

1. Negotiate a half-day off during the week.

2. Add a week time off for continuing education

3. 2 weeks vacation time + 5 days sick time, you get an additional day off per year for each (it's been proven that you will get sick more in your first year of practice)

4. If no orientation built in, then ask for a ramp up such as 2 weeks of 8 patient per day, 2 weeks of 12 patients per day, 4 weeks of 16 patients per day, then 20-24 thereafter (not sure what expected volume will be).

5. Bonus compensation??! And if not, then definitely negotiate for $110k and see where they meet you. $100k a year in Massachusetts is rather meager.

Lots of possibilities if you ask.

Good luck!!

Darth Practicus, FNP

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Thank you all so much! My professors also brought up the perspective that starting out in a slower clinic would be a good idea for the same reasons you both pointed out.

I did reach out the owner of the practice and let him know I was interested and would touch base once I actually pass my certification to discuss contract specifics and start date which he was agreeable to. I will definitely take the feedback on contracts into consideration! I'm terrible at negotiation but I am trying to get better at it as I don't want to undersell myself.

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After reading Darths post, I changed my mind. He has a very reasonable approach and the slow build up might be good. I was worried about the physician having no clue about NPs and just seeing you as a profit extender, but with a new practice you will have time to get to know one another and orient. Nice to see some good perspectives here.

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