Please help decide between Internal Med Clinic Vs Minute Clinic

Specialties NP

Published

Hi everyone,

I recently graduated from Family Nurse Practitioner school and just got my licence to practice. I am having a problem choosing between two offers in Houston, TX. Retail Clinic in Pharmacy offered me $50/hr (Minute Clinic) and I met a really awesome doctor who is offering Annual of $90,000 with some benefits, with 3 weeks paid vacation.

As a new grad, I am kind of wary about starting my first job at the retail pharmacy clinic. The good thing about this offer is it a full time employee position (W-2), with many benefits. The problem is that the hours of operation (extending till 7.30 to 8 pm in evening) does not sit very well for a single mother with a toddler to be picked up from daycare. But work days are 4 days a week.

The internal med position sounds to be a good position, but I was told it is Independent contract position (No W-2). Hours of work are very compatible with baby in daycare, as i can work Monday to Friday 8-5 or 9-6 or however I want to work. The office seems very supportive and the the MD very nice. I have known him for a while. I am not very familiar with Independent contractors and I was wondering how this works, especially with me having to do my own taxes?

1. Anyone knowledgeable with 1099 tax form to help me figure what annual of $90,000 on 1099 compares to $50/hr (roughly 36-37 hrs a week) on W2?

2. What do you all think about working in Retail pharmacy clinic vs Internal Medicine, especially for new grad?

Your prompt response is highly appreciated.

Hi Core0 After reading your post I had to look at the paper again. You couldn't be more right. I looked at the list of benefits and yes; it states "health, dental and visual coverage available, medical malpractice, CMEs worth 1K, productivity bonus an, paid holidays and vacation." All this as an independet contractor. This sounds more like a full time position with benefits on W-2, until I read where it talks about "base salary of $90K - paid monthly as contract employee." This base was negotiated to 95K. I asked for 100K, was offered 95. Haven't agreed to 95K but I said I'll think about it. I don't know whether to be happy or upset. Upset because I would basically be a w-2 employee being made to sign 1099 and be responsible for taxes that come with 1099 (which I don't know by how much more?) Or should I be happy because this is a job that gives me the independence to work out my schedule the way I want (well that's the freedom that comes with independent contractor right?), with the 'added benefit of getting the benefits that I wouldn't otherwise be getting as independent contractor smh? :unsure: No one taught us how to negotiate in NP school. All opinions welcome. No opinion is bad or unwelcome. Lets talk about this.[/quote']

I hope I can help a bit. Getting income on 1099 form is only a good idea if your are yourself is a small business owner or you indeed has a lot of "write offs": qualifying business expenses that you accumulate while performing your work and you can claim as a credit (reduces your tax obligation) when you file your taxes. "Qualifying" is a key here, as I belive you won't have a lot even with all those accounting tricks as IRA contributions, student loans interests, donations - you name it- because, for example, you're not paying anyone a salary, you're not paying for any office equipment and etc., you lovely boss is. It's is a really predatory practice to employ someone on 1099 as IC when in fact that employee technically constitute a w-2 category employee. They are just trying to raise their profits anyway they can.

As for you, think about that, as a 1099 income earner your are responsible for all of your taxes: 15.3% self-employment tax (social security and medicare contribution - your employer share that would have been paid if you were on w-2) PLUS (!) income tax - federal, state and/or local depending on laws where you live- which is roughly additional 8-17% of your income. Simple math: take away on average 25% (or more) of those $95,000 and now you have your "take home" number, which can be surprisingly not a lot. I would consult an accountant, preferrably a CPA, to see which way is more beneficial in your particular situation. Maybe, if flexibility is the priority now, with a small child and custody issues, take the hours, be prepared to earn not as much as hoped to, and keep on a look out for a better opportunity. You said you've recently graduated so I would assume it's just a starting salary and that first NP job that is what it is - first ;) It's a lengthy post, or well, never was guilty at expressing myself in "just a couple words". I wish you that everything works out for your for the best!

Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

The IM job gets my vote.

I have a question.

Were you told the IM position is 1099?

Because being under contract doesn't translate to 1099, especially since you mention they offer benefits.

Thank you so much [COLOR=#003366]CarrotChardonnay for your enlightening post. Sounds like the 95K on 1099 comes roughly equivalent to almost 85,000 as W-2 employee? Almost $ 43/hour (currently I'm making $45/hour as medsurg RN working PRN without benefits) I really wish there was an easy conversion calculator so I can compare apples to apples!

The more I learn about this Independent contractor option (1099) the more I feel like walking away. In fact, I am beginning to really hate the number 1099 itself. But then again I look back and realize I'm only a new grad NP with 4 years Medsurg experience. I do not have any ICU or ER experience. But I'm and NP regardless! I even learned that should she decide to fire me for one reason or another, I would not be eligible for unemployment benefits. The IM schedule is very very appealing but I feel like I'm being denied W-2 status, and I'm wondering what other tricks they would play on me!

I am trying to be realistic with my new grad status, but while at the same time realize I do have bills to pay, especially as a recently divorced single mom who needs to refinance her house in less than 6 months!

Minute clinic hours on the other hand are just so incompatible with my mommy status of a daycare aged baby. Today the MD's office is sending me the contract. I think I will tell them that I will sign it if they either change to w-2 status, or make pay $100k, which I had asked. I mean, I have two job offers and I'm even more stressed out than without any offers! As Carachel suggested a 4 days work, I might request to have a 10 hour day, so I can work probably from 7a-5.30pm. I might just bite the bullet and take the tricky offer without much expectation (in fact getting paid less than what I'm making as RN), and take it as a residency or internship. My goal would be to learn as much as I can absorb, equip myself with experience, which include seeing patients in office plus rounding in hospital plus LTACs and nursing home. With this kind of experience, I hope my FNP licence will be worthy of some decent income! I will plan to be as productive as I can be. By the end of year, I will have them significantly increase my numbers, or I'll be moving elsewhere, since I will have had some experience on my back, to decorate my Nurse Practitioner license.

Keep those comments coming... All opinion are welcome!

TX RN, I was not told that it will be 1099, but I'm assuming that's the whole point of them insisting on me being independent contractor than employee. The way they described the situation gives me the impression that it's 1099. They said I will need to set money aside to pay taxes etc plus I can deduct stuff like mileage (the job is only 7 miles from my home). I don't think with w-2 I would need to pay my own taxes, woould I?

I like your vote TX RN lol.... I'm thinking of looking at it as an ooportunity for growth, which allows me a flexible schedule with my child. In terms of money, I might just be making what I'm making now as Medsurg RN working PRN with no benefits. In fact, last time I worked fulltime with benefits I made $30/hr, a w-2 salary of about $ 60K, with benefits.

Based on what some have said, 1 year of Internal Med experience is better than 1 year of Minute Clinic nothing against Minute Clinic) experience?

Thank you so much CarrotChardonnay for your enlightening post. Sounds like the 95K on 1099 comes roughly equivalent to almost 85000 as W-2 employee? Almost $ 43/hour (currently I'm making $45/hour as medsurg RN working PRN without benefits) I really wish there was an easy conversion calculator so I can compare apples to apples! The more I learn about this Independent contractor option (1099) the more I feel like walking away. In fact, I am beginning to really hate the number 1099 itself. But then again I look back and realize I'm only a new grad NP with 4 years Medsurg experience. I do not have any ICU or ER experience. But I'm and NP regardless! I even learned that should she decide to fire me for one reason or another, I would not be eligible for unemployment benefits. The IM schedule is very very appealing but I feel like I'm being denied W-2 status, and I'm wondering what other tricks they would play on me! I am trying to be realistic with my new grad status, but while at the same time realize I do have bills to pay, especially as a recently divorced single mom who needs to refinance her house in less than 6 months! Minute clinic hours on the other hand are just so incompatible with my mommy status of a daycare aged baby. Today the MD's office is sending me the contract. I think I will tell them that I will sign it if they either change to w-2 status, or make pay $100k, which I had asked. I mean, I have two job offers and I'm even more stressed out than without any offers! As Carachel suggested a 4 days work, I might request to have a 10 hour day, so I can work probably from 7a-5.30pm. I might just bite the bullet and take the tricky offer without much expectation (in fact getting paid less than what I'm making as RN), and take it as a residency or internship. My goal would be to learn as much as I can absorb, equip myself with experience, which include seeing patients in office plus rounding in hospital plus LTACs and nursing home. With this kind of experience, I hope my FNP licence will be worthy of some decent income! I will plan to be as productive as I can be. By the end of year, I will have them significantly increase my numbers, or I'll be moving elsewhere, since I will have had some experience on my back, to decorate my Nurse Practitioner license. Keep those comments coming... All opinion are welcome![/quote']

Sounds like a really good plan! Just my opinion.

Thank you so much [COLOR=#003366]CarrotChardonnay for your enlightening post. Sounds like the 95K on 1099 comes roughly equivalent to almost 85,000 as W-2 employee? Almost $ 43/hour (currently I'm making $45/hour as medsurg RN working PRN without benefits) I really wish there was an easy conversion calculator so I can compare apples to apples!

The more I learn about this Independent contractor option (1099) the more I feel like walking away. In fact, I am beginning to really hate the number 1099 itself. But then again I look back and realize I'm only a new grad NP with 4 years Medsurg experience. I do not have any ICU or ER experience. But I'm and NP regardless! I even learned that should she decide to fire me for one reason or another, I would not be eligible for unemployment benefits. The IM schedule is very very appealing but I feel like I'm being denied W-2 status, and I'm wondering what other tricks they would play on me!

I am trying to be realistic with my new grad status, but while at the same time realize I do have bills to pay, especially as a recently divorced single mom who needs to refinance her house in less than 6 months!

Minute clinic hours on the other hand are just so incompatible with my mommy status of a daycare aged baby. Today the MD's office is sending me the contract. I think I will tell them that I will sign it if they either change to w-2 status, or make pay $100k, which I had asked. I mean, I have two job offers and I'm even more stressed out than without any offers! As Carachel suggested a 4 days work, I might request to have a 10 hour day, so I can work probably from 7a-5.30pm. I might just bite the bullet and take the tricky offer without much expectation (in fact getting paid less than what I'm making as RN), and take it as a residency or internship. My goal would be to learn as much as I can absorb, equip myself with experience, which include seeing patients in office plus rounding in hospital plus LTACs and nursing home. With this kind of experience, I hope my FNP licence will be worthy of some decent income! I will plan to be as productive as I can be. By the end of year, I will have them significantly increase my numbers, or I'll be moving elsewhere, since I will have had some experience on my back, to decorate my Nurse Practitioner license.

Keep those comments coming... All opinion are welcome!

The real issue is legally can you be a 1099 employee?

Take a look at this article:

http://www.learnvest.com/knowledge-center/the-difference-between-a-1099-and-a-w-2/2/

If you're an independent contractor, you likely:

  • Set your own schedule.
  • Use your own personal method for finishing assignments.
  • Accept tasks on a case-by-case basis--and can turn down offers of work.
  • Supply your own tools.
  • Have more than one client.

Basically, if you do your job well and finish it on time, the company doesn't have much contact with you while you're working.

If you're an employee, you likely:

  • Have assigned hours or a set schedule.
  • Get trained by the company in a certain method.
  • Complete any and all work assigned to you by a manager.
  • Are provided the tools and materials necessary to finish your work.
  • Have only one employer.

For most people that work in medicine they resemble a w2 employee more than a 1099. Presumably they aren't going to tell you how to practice, but they are setting your hours and patient schedule (assigned work) and providing the tools to finish the work (office, compute etc).

It would not be unusual for a small business to be doing this because they don't understand the law.

TX RN, I was not told that it will be 1099, but I'm assuming that's the whole point of them insisting on me being independent contractor than employee. The way they described the situation gives me the impression that it's 1099. They said I will need to set money aside to pay taxes etc plus I can deduct stuff like mileage (the job is only 7 miles from my home). I don't think with w-2 I would need to pay my own taxes, woould I?

As a 1099 you have to pay taxes quarterly (all taxes including employer and employee payroll). As far as deductions the rules are very complex. Unless you have a lot of equipment to depreciate or a home office to expense its hard to see a value for you. Usually 1099 positions are an advantage to employers since they don't have to worry about benefits. The general thought is that a 1099 positions (if legal) should pay around 25-30% more than a w2 to account for lack of benefits and payroll taxes. In your case the only real benefit I see is that they don't have to pay payroll taxes (so you should be getting around 7% more).

So, I received the contract but haven't signed, don't even know whether or not to sign. Very confusing details:

MD's business is referred to as "Employer" and I am referred to as "Nurse Practitioner".

Benefits are said subject to change based on cost or availability.

My relationship with MD is described as the Nurse Practitioner is an independent contractor of Employer for the purposes of the duties performed under this agreement.

Is it possible for me as nurse practitioner to be an "independent contractor" with the MD's practice as my "employer?"

Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

Best you take this to an attorney.

Trust me, best $300 you can spend.

Thank TX RN. I really would love an IM job, but the contract seems more of a roller coaster than anything. Seems like I can find myself screwed up. Last thing I want is to find myself illegal independent contractor.

Specializes in orthopedic/trauma, Informatics, diabetes.

Not an NP, but years of self-employed. As an independent contractor, you will have to have your own liability and health/disability, etc insurances. good news is that you can write off a ton of stuff on taxes. Check w/lawyer-accountant.

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