Equal work for Equal Pay

Specialties NP

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  1. Equal Pay for Equal Work

    • 7
      Yes Equal Pay for Equal Work
    • 24
      No Not Equal Pay
    • 6
      Pay Based on Quality Outcomes

37 members have participated

What are your thoughts folks? As an sNP, I think if we do the exact same work we absolutely deserve the same high salary that physicians get.

Some of my peers in medical school say that education and qualifications deserve higher pay i.e. A college PH.D professor gets paid more than a masters trained high school teacher, even if they are both teaching AP biology/Intro to Biology 101.

I understand their Point of View, but I think it's unfair that just because we aren't learning as much material, but going to be dealing with many of the same cases and patients, that we do not deserve a physician's salary. Studies again and again show that NP's do an equal job if not better job than physicians at correctly diagnosing problems and treating patients. Some would argue that in a quality outcome based system, Nurse Practitioner's deserve even more pay because our results are better!!

I think this is just a reworded question that is asking almost the same thing as the last one you asked.

Economics will determine who gets paid what, not who deserves what.

There will soon be probably too many nurse practitioners, so even if somebody says they do equal work for equal pay it probably won't happen unless they all go into independent practice. This really only applies to primary care and psychiatry since those are the only footholds that allow nurse practitioners nearly identical privileges compared to the docs. You can mention acute care and women health but those are still pretty facility specific on what they are allowed to do.

supply vs demand

i start med school after being an np for a few years, so in an attempt to be impartial, i think it should be value based care.

XYZ group gets X amount of dollars to manage Y number of patients. So if a group of nurse practitioners can manage the same group of patients for the same cost then sure, give the group the same amount of cash, thats fine by me. I believe nurse practitioners would order more tests and refer more stuff out than most physicians though, so they would probably not get to keep as much as the money (at least on average), and especially when considering newer graduates.

If your really asking whether or not nps do the same thing as docs (in primary care) to the same quality, its pretty person specific. A new grad NP vs a new grad fp doc, of course the fp doc will more than likely be able to handle ALOT more. 5-10 years later, the gap is probably pretty much narrowed though since they both have probably reached the knowledge ceiling needed for primary care ( or at least come close). Depends on the person though.

The specialist groups will probably always be can by docs though, i do not see them giving up ground on this. Especially specialties where one wrong move can end somebody's life.

It is worrisome though, as others have described, the decreasing standards of education and admission criteria for a lot of these nurse practitioner schools. I feel this will negatively impact NPs in the future.

If somebody did a study comparing outcomes of complex cases across the country in primary care and took into account # of referrals, tests ordered, outcomes, etc, I do believe the docs would come out on top though. I am somewhat weary of the studies posted on these boards as they are pretty much conducted by nurses. The bias in scientific studies is evident in all fields, and I cannot say that the 14000 or so hours of additional training that the docs receive is completely worthless in comparison to the 700-1000 that nps get. I am sure there are diminishing returns in benefit after a while, but one does not experience all the disease he or she needs to see in 700 hours, unless you are very lucky lol. But again, I would say the gap closes over time, but it is obvious for new graduates.

Specializes in Oncology.

This question is as ridiculous as the last post asking if we should get rid of physicians altogether.

NPs should not get the same amount of pay. Physicians are much more rigorously trained. NPs can do many of the same things physicians can do in certain settings and provide quality patient care and outcomes, but NP care is not "better" care and whether or not it is equal care is really very individual. Physicians have put in the time, effort and years of training to earn what they do.

OP, what exactly is your agenda?

OP, what exactly is your agenda?

In an earlier post i think he didn't get into medical school, he seems to be having some disgruntled feelings towards docs now. Not quite sure how it will help his future but to each their own I guess.

Here is his earlier post. There are several more like it in other sections.

Nursing school followed by ER followed by MSN. Considered applying to med school, but did not do well on the MCAT. I think all of us would have been great physicians, but there are just so many barriers and exams to jump through and it is much more cut throat with all the crazy premed psychos.

Consider the years of school and training they do, they earned that high salary. Why should NP's deserve the same when they only go through a 2 year training program? If you find it unfair, go to medical school.

Success always looks easy to those who weren't around while it was being earned.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

On the other hand, I think this is a legitimate question unlike the one the OP posted before in another thread.

Consider the following scenario:

A family practice physician sees a new patient to establish routine care of a healthy middle aged male with no prior histories. He performs a physical exam, checks vital signs, orders labs, and determines that screening diagnostic tests are required. He writes up a note on the patient and bills the insurance company for $100.

An FNP sees another middle aged male with the exact same profile as the one the physician saw and performs the exact same procedure as the physician but can only charge the insurance company $85 or 85% of what a physician can charge because that's what the CMS rules state.

If you look at it, both providers did the exact same thing. The argument against making reimbursement equal between physicians and NP's is that NP's offer a more cost-effective alternative to the care physicians offer by charging insurance companies less. That disparity, however, is also preventing NP's from having a level playing field with physicians.

In some institutions and practice settings, physicians insist on billing services alone and not having the NP's on their team bill in order to capture the 100% reimbursement. This devalues the NP in states where a collaborative practice is required. There are good arguments on both ends of the debate.

This is not about NP's asking to be allowed to perform the full scope of physician and surgeon practice. What it is is asking if NP's should be paid the same as physicians if they bill for the exact same CPT code. I'm also not excluding PA's in this argument.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

And just as an aside...the new Medicare rules under ACA actually now allows CNM's to charge 100% of the physician billing fee.

Specializes in ED.

In a prior career I was asked by a new hire what I did to deserve such a high level of pay. One of my colleagues took him aside and explained we are not paid on what we do but on what we know. With 3-5 years experience someone can easily acquire the skills for the routine tasks but when it all hits the fan you need someone with a proven track record. This is analogous to the NP/Physician situation, yeah 99% of the time the routine decisions are easy but when it truly is a Zebra you want someone that knows what Zebras look like.

Id say in the future NPs will be paid the same for CPT codes. I doubt that as employees though they will ever be paid the same as a physician though.

Indépendant practice laws may change that though. But don't let yourself be fooled... even an NP owned practice would probably pay employed NPs less than a physician. It will probably only benefit the partners/owners of practices, and with more practices getting gobbled up by hospital systems independent practice may not help NPs out as much as we hope. Admins will use any excuse out there to not pay people the same amount of cash.

If an NP set up shop in the rural west as a solo or partner practice though i would say he or she could make bank as long as you can get insurance companies to pay up.

I mean CRNAs have full practice authority in many states but they still don't make as much as anesthesiologists do in the same setting. I do not think the result will be much different from NPs.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
This is analogous to the NP/Physician situation, yeah 99% of the time the routine decisions are easy but when it truly is a Zebra you want someone that knows what Zebras look like.

But the billing system for medical procedures and services (aka CPT codes) already ensures that more complex decision making by providers in the process of patient evaluation and management are designated at a higher level and with a higher reimbursement than straightforward and routine encounters. That's why specialists make a lot more money than primary care providers. The argument remains, if an NP performs the exact same evaluation and management as a physician counterpart (i.e., same level of complexity), should reimbursement be equal?

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