The job outlook in my area is pretty nice. I am recently certified and licensed NP and have already had 3 interviews with 2 of the opportunities showing great interest. I believe the next step would be an offer of employment, but the salary has not yet been discussed. I am not sure how to approach this situation, so it would be great if a seasoned NP could chime in for some guidance.
I don't want to get lowballed or short change myself as I know there are many jobs in the area and not enough NPs to fill them (as told by a local recruiter). A lot of these facilities/offices are using locum tenens.
I just have to ask..what areas do you all live in where a new FNP (I'm assuming this is FNP, not psych?) feels that asking for a 100K salary for full benefits is within reason?
Texas. It shouldn't really matter where you live though. If you're going into a busy practice where you're going to be expected to see around 20 patient a day, you're going to be pulling in over 500k a year. It doesn't make sense to take something low like $80k. You could ask for $200k and you boss is still pulling down a very handsome profit for your work.
Ok....So I did receive an offer today. It was on the lower end of the spectrum, which is to be expected, but now is my time to counteroffer. After the offer was made and sent in writing I said thank you and that I needed some time to look everything over....salary, benefits, etc and that I would get back with her to further discuss everything after the weekend.
What is the best way of going about making a counteroffer for the higher salary?
Thanks!
If you have classmates that you know are receiving better offers, or know other NP's in the area doing better, use that to justify your increased pay.
If they say it's because you're "new" ask if that means when you're seeing a full patient load your pay will be increased. Insurances and medicare/medicaid could care less if you're new or the most seasoned NP in the world, they're reimbursing the same.
As I said before, ask about incentive bonuses because a good incentive bonus package could significantly improve your salary.
Sorry, but I have yet to know of any new FNP who jumps in and is profitable for the office for at least 6 months. You actually cost the office for awhile. Any new grad coming in to most of the offices here and demanding 100k with zero family practice experience as an NP would hear crickets in the weeks to come after the negotiation. For an experienced FNP (I'm not talking psych or other specialties) that is a normal rate here. Also, smaller individual owned offices are probably not going to offer much in the way of health bennies etc.
Also... Being paid less when you are new isn't a reflection of what insurance reimburses or doesn't reimburse... It's all the same. But the volume of patients /day is much less. This is why new grads are not really profitable in the beginning. They are usually slower.
i am all about negotiating. Don't get me wrong. But I think it's more realistic for a new FNP grad to ask for a certain rate to start and then a review at three or six months with sn agreement to bump up salary by say 5-7k at that time of they are up to speed and quality.
Sorry, but I have yet to know of any new FNP who jumps in and is profitable for the office for at least 6 months. You actually cost the office for awhile. Any new grad coming in to most of the offices here and demanding 100k with zero family practice experience as an NP would hear crickets in the weeks to come after the negotiation. For an experienced FNP (I'm not talking psych or other specialties) that is a normal rate here. Also, smaller individual owned offices are probably not going to offer much in the way of health bennies etc.
That's a shame. I sure am glad I don't live in your area. Even in Texas where it's very physician driven, the market is such that they have to pay us well. I totally understand if you're in an oversaturated market where you basically have to take what you can get though.
I'm also not sure about your 6 month profitability estimate. I started seeing patients on my own after a good week of orientation (also where I did my final semester rotation so I knew the system well) and was rounding in rehab facilities on my second day. My boss does a great job of being transparent with our returns because we get incentive bonuses, and for my very first month I pulled in over 20k at the rehab facilities and about 15k in the office. $35k versus the $9k he paid me is a tidy profit and my numbers have only gotten better. Even factoring in my full benefits doesn't eat away too much at the profit margin.
I guess if a place is giving you a long orientation that spans several months, you're absolutely right that they aren't going to be profitable. But at least where I am, that sort of thing is almost unheard of, and the orientations are brief, and we hit the ground running very fast.
Also... Being paid less when you are new isn't a reflection of what insurance reimburses or doesn't reimburse... It's all the same. But the volume of patients /day is much less. This is why new grads are not really profitable in the beginning. They are usually slower.
i am all about negotiating. Don't get me wrong. But I think it's more realistic for a new FNP grad to ask for a certain rate to start and then a review at three or six months with sn agreement to bump up salary by say 5-7k at that time of they are up to speed and quality.
Even if a new grad in a primary care practice only averages 10 patients a day for a year, they're still going to rake in over a quarter of a million dollars, and that's assuming they never perform a single procedure or skill.
Your negotiation tactic is very sound and great advice, however, I have yet to see an NP contract that stipulates for that. Most contracts I have read and seen in person usually are written on a yearly or multi-year basis. Which is how your employer gets you. Sure worst care scenario is you aren't pulling your own weight for 6 months by your own estimation, but after that you become a ridiculous cash cow for your practice yet are still making your new NP pay. I'm thankful I was employed by a provider that knew exactly what we bring to the table and went out of his way to make sure we are well taken care. Too many hiring physician's here presume we will work for peanuts, and too many NP's are so desperate that they'll work for it.
Did the offer of 86,500 include any incentive bonuses? I think that would make a big difference in the overall package. I recently made the switch to a family practice office with a similar salary but I have the ability to make up to $25,000 more based on productivity. I also received a sign on bonus, relocation package, 4 weeks PTO, 1 week CME plus $2,000 for CME and benefits. The salary is unfortunately pretty standard for my area but feel the rest of the package helps.
That's a shame. I sure am glad I don't live in your area. Even in Texas where it's very physician driven, the market is such that they have to pay us well. I totally understand if you're in an oversaturated market where you basically have to take what you can get though.
I'm also not sure about your 6 month profitability estimate. I started seeing patients on my own after a good week of orientation (also where I did my final semester rotation so I knew the system well) and was rounding in rehab facilities on my second day. My boss does a great job of being transparent with our returns because we get incentive bonuses, and for my very first month I pulled in over 20k at the rehab facilities and about 15k in the office. $35k versus the $9k he paid me is a tidy profit and my numbers have only gotten better. Even factoring in my full benefits doesn't eat away too much at the profit margin.
Again, I'm talking about pure Family Practice. No specialties, nursing home visits etc. And at ten patients a day you ARE pulling in money, but subtract that from the overhead i.e. your part of the MA, the building rental/lease, etc. etc. It is not what you are describing. And it is actually very standard in my area (Texas) to negotiate a significant raise after a 3-6 month learning curve. At least for all of the five to six NP colleagues I keep in touch with regularly. But we all have worked at smaller, individually owned offices (vs large groups) so maybe that is why?
Again, I have learned to negotiate and feel I am fairly compensated. But I think it is a little assuming of a green new grad to come into even the most amazing market as a new FNP and think they are going to get 100K. It doesn't hurt to ask so I agree there! I could almost hear the snort/laugh when a new PA came in to "negotiate" with her big stack of papers/salary surveys (which were wrong, by the way) and asked for $110K.
This post was very informative for me, thank you. I'm currently located in the south and have been scouring job openings for NPs within the healthcare system I currently work in, to give me an idea of what salary range to expect. Of note, I'm a FNP student and will graduate the next 3 years. It saddens me that the salary range for advanced practitioners in the health care system I work for is 72k-108k. I feel that this is a fairly low number for the advanced training and preparation we endure to become providers.
Sent from my iPhone using allnurses. Pardon for any misspelled words, I blame it on auto-correct.
Did the offer of 86,500 include any incentive bonuses? I think that would make a big difference in the overall package. I recently made the switch to a family practice office with a similar salary but I have the ability to make up to $25,000 more based on productivity. I also received a sign on bonus, relocation package, 4 weeks PTO, 1 week CME plus $2,000 for CME and benefits. The salary is unfortunately pretty standard for my area but feel the rest of the package helps.
This is a package that I consider pretty solid. All the benefits push it higher, plus the extra income potential is nice.
I'm all about contract that create productivity incentives. It's win win for you and the employer.
Again, I have learned to negotiate and feel I am fairly compensated. But I think it is a little assuming of a green new grad to come into even the most amazing market as a new FNP and think they are going to get 100K. It doesn't hurt to ask so I agree there! I could almost hear the snort/laugh when a new PA came in to "negotiate" with her big stack of papers/salary surveys (which were wrong, by the way) and asked for $110K.
I'm a new grad (in Texas as well) and walked into a contract for almost $110k (initial offer was $90k) with full benefits and a bonus plan that could very well double the salary. I work for a private physician and it's just myself, another NP, and him. That's it. Many of my classmates are all pulling over $100k, and some classmates that are working for a large hospital group get a flat $135k with full benefits.
If you're walking into a low volume practice with fewer patients, and aren't expected to hit a certain quota, sure, a lower salary is likely justified. However, if you're going to a practice where they're expecting 20 or more patient visits in a day, you are completely justified in asking for that salary. So that's another important point to make...when negotiating, ask what the expectation of patient volume is. If they're expecting a high quota, you should expect a higher salary.
Overall, I guess my outlook is different because I'm with a practice that discloses full financials and know exactly what myself, as a new grad am generating. Although I consider myself to be efficient and effective, I don't think I'm that much more advanced than other new grads, and believe they can do the same.
Alicia777, MSN, NP
329 Posts
Salary.com should give you an idea if no ones willing to cough up numbers for you. Start $5 higher than you'll settle for and be brave!