Hi everyone,
I have recently passed my AANP exam and I have been offered a job working for a doctor who I have the utmost respect for, and who I have worked alongside for years in the acute care setting. He emailed me a contract that he wants me to consider. I am posting this here to hopefully get advice, guidance, and wisdom from those who have been in similar situations, and understand the value of what I can bring to the table better than I do. I will try to keep the details direct and to the point, but if I leave any pertinent information out, please point it out and I will reply.
Background:
I will be joining a small group consisting of the physician and another NP. am a FNP by trade and the job offer is primarily in the acute care setting, where I will see patients on a general medical floor and a telemetry floor. Eventually, I may see "our" patients in the ICU, but there are usually intensivists there. The other NP primarily does nursing homes, rehabs, and home care, but she will be in the hospital once a week.
The physician is a nephrologist, and we work for a small community hospital in the Northeast. He usually sees the most patients, due to the fact that the family doctors in the community have a deal with him where they admit their patients under his care, instead of the not-so-reliable hospitalist group. Therefore we manage the total care of the patients (H+P's and medicine follow-ups) as well as all of the renal consults.
The Contract: The contract has headings called "Defined Work" and "Non-Defined Work." The Defined Work heading states that I will be rounding on patients, doing notes, and taking calls for the hospitalized patients 4 days a week. I will also have to be on-call for 2 nights a week, every 3rd weekend, and 2 holidays per year. Additionally, the contract states that I must see at least 18 patients per day in the hospital (I'm not sure what that means because I have to see all of the patients we have in the hospital, whether it is 18, less than 18, or more than 18). It further states that I am responsible for doing dialysis rounds on 3 shifts of dialysis patients at the dialysis center (2 miles from the hospital).
The "Non-Defined Work" is the work I do that is not in the hospital. This includes the patients I would see in the nursing home, subacute rehab, assisted living center, and home (yes we do home visits too via the transitional care program). Adding this to my schedule will now mean I am working 2 more days a week in addition to the 4 days I'm in the hospital.
Compensation:
Here are the compensation details of the contract:
Base salary: $80,000/year - and compensation will be bi-weekly
Base salary after 1 year of employment = $85,000/year
Base salary after 2 years of employment =$90,000/year
I must see 18 patients in the hospital. For each patient I see over 18, the incentive is $25/patient
I will receive 60 percent of the collections for the Non-Defined Work I do (nursing homes, rehabs, home visits, etc)
Employer will contribute 50% of cost towards my health insurance plan per year.
3 weeks paid vacation per year.
Employer will pay the cost of my hospital dues, DEA registration, , professional licensure and certification fees, and $500 towards CME's.
Negotiation Questions:
Is this acceptable to anyone? I would like to negotiate for a higher base salary as I feel $80k/year for 4 days a week in the hospital seems low...especially if these pay-scale sites for NP hospitalists are accurate. Also, N.J. usually has higher salaries compared to the rest of the U.S. I was making really close to $80k as an RN working 3 days a week and my per-diem job on the 4th day. I would also like a 401k with match, and 80% towards my health insurance plan (i'm a single male with no kids). And $25 incentive pay for each patient over 18 seems low as well. I know I could make a lot of money if I work 6 days a week doing 4 days in the hospital and the other 2 in the nursing homes, rehabs, home visits, dialysis rounds, etc....but, at the same time, I don't want to burn myself out early. I'd like some work-life balance.
Other Thoughts:
We would be a very small group so I can't say I don't want to do the "Non-Defined Work," because I need to share that responsibility. I always liked the idea of a 60/40 split too, but he told me that it is hard to make that work in the acute care setting and that's why he would rather do a salary.
I appreciate any and all input on this matter as I'd like to go in to the negotiation meeting prepared and with a better understanding of the value of the nurse practitioner than I have now.
