NP productivity info?

Osorry1 · May 15, 2005

HI. I am trying to find out some information about other NPs Productivity. All I can find on the internet is about salary, benefits, etc. And on most websites it tells how to negotiate salary based on how many patients you can see in a day. And i am trying to convince my physican employer that I see a lot of patients per day compared to an average NP to hopefully increase my salary because i work so many hours. Also, I am trying to decide on whether to try to make a job change due to this. I did not go to school so long and work so hard to make someone else rich, ya know? thanks for any info. please give me any advice you can, and other nurses who are going to be NPs soon.... TAKE NOTE.

At our facility, we (NPs and MDs) are paid salary plus productivity bonus. They figure out overhead and other fees that equal our salary, benefits, etc. Based on what we cost them per 6 months they give us 70% of out over production back each quarter.

Example:

If I worked 1025 hours from 7/1/04-12/31/04 ( I'm taking these numbers from my last production report)- I was expected to generate 182K in revenue for the company (hours worked times what they figure I cost them as an employee).

I generated 209K in revenue for the company for a total over production of 26K. The company gets 30% of the 26K, I get 70% as bonus (18K before taxes).

That is one example.

overworkedNP · May 15, 2005

At our facility, we (NPs and MDs) are paid salary plus productivity bonus. They figure out overhead and other fees that equal our salary, benefits, etc. Based on what we cost them per 6 months they give us 70% of out over production back each quarter.
Example:
If I worked 1025 hours from 7/1/04-12/31/04 ( I'm taking these numbers from my last production report)- I was expected to generate 182K in revenue for the company (hours worked times what they figure I cost them as an employee).
I generated 209K in revenue for the company for a total over production of 26K. The company gets 30% of the 26K, I get 70% as bonus (18K before taxes).
Thanks for the info. Do most of the NPs in your area get production bonuses like this? I work in a private family practice with 4 physicians who are partners who own the practice, and then there are a total of 2 NPs. Both of us NPs are getting very frustrated because of the long hours we are working and the amount of patients we are having to see. We are on salary so it is not benefiting us at all when we work 50 or more hours per week and we are getting burnt out fast. I have been there for 6 years now and have built up quite a patient base. Every month we get our productivity numbers and also it tallies up monthly until end of year. last year i billed out 432,000. and only got a 3,000 raise, the year before was around 398,00 and i got a 2000 dollar raise. they dont really go according to our productivity at all when determing anything and so we are both wondering why in the world we are doing this and working so much for us to not get any benefit from it. The partners split the earnings at the end of the year according to their productivity as well as their salary, but we are not receiving anything at all other than just a salary which is around 70k presently. They say it is what an average np salary is and that we should not complain and that the benefits are good. which they are okay, but are the same as most other nps. We NPs there see approx 30-45 patients per day and while we close at 5, we are usually there until around 7 because of all the walk-ins, which we are expected to see until there are no more left. They say these visits are the businesses "Bread and butter". Did they offer this bonus toyou or did you present it to them? any advice on how i can convince them to pay us by productivity? thanks for your input.

Osorry1 · May 15, 2005

Thanks for the info. Do most of the NPs in your area get production bonuses like this? I work in a private family practice with 4 physicians who are partners who own the practice, and then there are a total of 2 NPs. Both of us NPs are getting very frustrated because of the long hours we are working and the amount of patients we are having to see. We are on salary so it is not benefiting us at all when we work 50 or more hours per week and we are getting burnt out fast. I have been there for 6 years now and have built up quite a patient base. Every month we get our productivity numbers and also it tallies up monthly until end of year. last year i billed out 432,000. and only got a 3,000 raise, the year before was around 398,00 and i got a 2000 dollar raise. they dont really go according to our productivity at all when determing anything and so we are both wondering why in the world we are doing this and working so much for us to not get any benefit from it. The partners split the earnings at the end of the year according to their productivity as well as their salary, but we are not receiving anything at all other than just a salary which is around 70k presently. They say it is what an average np salary is and that we should not complain and that the benefits are good. which they are okay, but are the same as most other nps. We NPs there see approx 30-45 patients per day and while we close at 5, we are usually there until around 7 because of all the walk-ins, which we are expected to see until there are no more left. They say these visits are the businesses "Bread and butter". Did they offer this bonus toyou or did you present it to them? any advice on how i can convince them to pay us by productivity? thanks for your input.

I know of some NPs that are paid salary and production, it's likely we are the exceptions. The productivity option was part of my employment offer, and they say that other NPs before me had this same salary.

My contention has always been that if insurances are paying us 80% of what MDs make, then my salary should be about 80% of theirs. I know this is naive, but the CEO actually admitted the financial advantage to companies to having NPs on lower salaries as the companies absorb the difference in the 80% of what we're reimbursed - the paltry salaries they may pay us. I've also used this strategy with the CEO to get nice salary increases the 2 years I've been here (over 5K each time). And we all work 8-5pm and usually no more, but when do go over, that counts in our productivity.

We're currently reviewing potential changes in our company and moving to straight salary, which will be set by current salary plus bonuses for past years, so I'll still do ok should they change to that.

My suggestion would be to find you total costs to the firm- salary, benefits, your percetage of office overhead, then compare that to your production and your salary. Offer to negotiate for a larger percentage of your overage, showing them the numbers (currently as a provider with no bonus, the partners are reaping the dollars from your excess labor) or suggest a buy in as a partner for a certain percentage of bonus based on the buy in amount.

We actually had a class in school that worked with us on these numbers and negotiation, which many MDs don't learn until they're out working. It bored us at the time, but we appreciate it now.

spaniel · May 16, 2005

Hi there- I'm sorry if this is a bit "off topic" but I truly was looking at the workload/burnout issue you describe. I'm an "older" nurse with many years of psychiatric nursing and have been seriously looking into a psych NP program. Actually I got accepted into one that was really competitive (in large part because of low tuition) and I turned it down.

Well anyway, to cut to the chase I'm thinking of going to another psych NP school... but posts such as this REALLY make me think twice.

I guess the reason I emphasized my age (52) is that I do not think I could tolerate this type of business deal. Certainly I would not have the stamina for that kind of workload. But also I do not think I would enjoy practicing in this way from a "personal satisfaction" point of view.

Is there anyway you can cut a nitch for yourself at some point? I know a crew of NPs who do their own "incontinence program". Yes, there's need for some oversight but not mass scheduling as you describe.

Hey... while you are at it- DO I make sense regarding my reaction to noting my own limits regarding stamina??? I am just so on the fence regarding starting a program as I'm a bit worried that I'd just end up facing a glut or facing a bad corporate medical environment. Thanks. And the best to you NPs. You absolutely do deserve a greater cut that's unquestionable.

sgent · Jun 30, 2005

Take a look at MGMA for productivity numbers (medical group management assoc). They put out a great book for that kind of thing on an annual basis.

I've seen probably 1/2 and 1/2 -- places where productivity bonuses are common and where they are not.