Please help decide between Internal Med Clinic Vs Minute Clinic

[APN Under Construction]

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.

[Theoxenia]

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.

I agree core0 it is mostly illegal, but difficult to prove it and fight against it. I just see that OP is not in the best bargaining position. So what do you think happens if the OP tells the IM doc that she cannot do that? My guess, the doc would politely agree, go into lengthy explanation why she needs it, and look for somebody else. I saw it frequently happen: use of 1099 when in actuality it is w-2, they are saving on taxes and so difficult to hunt them for this.

[Theoxenia]

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.[/quote']

Excellent point on liability insurance! Forgot to mention that! You would need to buy your own otherwise what happens if someone decides to file a lawsuit?!

[APN Under Construction]

I wrote to the manager seeking clarification if this is w-2 position but haven't heard back. As a new NP I agree that I may not get my dream job as first job, but also need to be careful not to find myself jobless with legal issues hovering over my license.

I think I might have to tell them I will not take 1099 position. Sounds too complicated for me, especially since I feel like I would be more of an employee than Independent contractor. I might just have to walk away from this one, as I did with another contract offered by cardiologist that wanted me to sign strict "contract not to compete." I'm sure another opportunity will come across.

Right now I do work same hours as Minute Clinic. I might just take MC offer and leep looking FP or IM opportunity.

[zmansc, ASN, RN]

First, I'm not an NP, so take my advice with that grain of salt.... lol

Second, 1099 vs W-2. It appears (calling you employee, then saying independent contractor) that the IM doc is mixing the two statuses. I would suggest you approach it as: "I don't want any confusion on my status that is going to bite me or you later on. I.e. if he pays you as a 1099, but then get's audited the IRS can and will say, nope, he was an employee, pay the back taxes (even if you paid them) and these massive fines. Never a good position to be in, but you are catching it during the negotiations and are willing to help the Doc clarify the contract and situation. I would suggest as was suggested above, contact a contract lawyer and get some input on this.

Third, $$ diff W-2 vs 1099. Take figures with you (might want to have an accountant help you) On the salary adjustments necessary to match XX$ W-2 to YY$ 1099. In other words, I understand you are offering me $90k (or whatever it is) as a 1099 contractor, backing out the extra taxes that works out to $86k W-2. You can use these figures to show him that 1, your looking for a fair number irregardless of the employee status; 2, your seriously interested but not wanting to be taken advantage of;

Forth, I would suggest you make a list of the benefits you want (vacation, malpractice, health, dental, etc.) So that you can negotiate these as well. Do a little research from your offers, and from other postings on this site. When you get stuck a few dollars apart, take into account what you are getting in benefits as well and maybe you can meet in the middle that way.

Finally, I've negotiated a lot of contracts and this one doesn't sound too far off base, just sounds like it still needs a few tweaks. Take your time, don't rush it, keep the emotions low, and realize if the IM doc is the least bit flexible you should be able to have a great job with a good salary straight out of school! No small feat in most professions.

[APN Under Construction]

Thanks everyone for your responses, you guys rock! As a new NP, or employee not familiar with different types of taxation, it can be very confusing. In fact, had one of my friends not told me about 1099 I wouldnt have had any clue of what this entails!

zmansc , I read though your comment and thought about the whole thing. You are right on the money! I visited an accountant and he was just puzzled about the whole situation. In fact, he wondered how they would be able to provide me with medical insurance, while I am not an employee. Then the MD's practice referring to themselves as the "employer" didn't make any sense either. An independent contractor is technically self employed. So when they talk about employer in contract, it doesn't make sense whose employer? (correct me if I'm wrong). I think someone is trying to get this MD into the 1099 situation but seems like they have no knowledge of the law. See as an independent contractor it is somehow difficult to negotiate for benefits. They did offer me some benefits though.

its been such a roller coaster of emotions and decisions!

Since my heart is with IM, and the schedule works with my baby, I might just have to bite the paycut and follow IM. Pay difference will be at least 10K but as a mom, sometimes you just have to make sacrifices. In 1 or two years, I should be a well experienced NP (thanks to getting on my feet with them). They will pay me what I'm worth or somebody else will.

Still taking opinions :-)

[TX RN]

Negotiate for productivity bonus.

[APN Under Construction]

Thanks TX RN. Contract states I will get yearly bonus based on productivity. When i asked to increase base further, they said they can increase, but do away with prodictivity bonus. So at this point I wonder: do I want $5K increase now without bonus or forget $5K and wait for productivity bonus (which I don't know how much it will be)

[BlueDevil,DNP, DNP, RN]

How is the productivity bonus going to be calculated? That is the million dollar question. In all likelihood, after a learning curve you are going to do better with a productivity bonus, but there is a lot of missing information there.

[TX RN]

How is the productivity bonus going to be calculated? That is the million dollar question. In all likelihood, after a learning curve you are going to do better with a productivity bonus, but there is a lot of missing information there.

+1 on this.

[sd1294]

I am a NP at Minute Clinic for the last 5.5 years. The pay is great, benefits very nice, hours aren't always the greatest but we self schedule so you can have flexibility. I have 3 kids under the age of 8 and no real family in the area so I understand the childcare issues. I work full time and couldn't be happier. Last year I worked part time in a family practice office too, loved the work and the patients, but the MD wanted quantity more than quality. I just couldn't continue to work under that pressure. As far as "cookbook" medicine....I have been an NP for 20 years now and when I see something that is outside of our guidelines, all I have to do is confer with my collaborating MD and typically they agree with my plan. I would be happy to answer any other questions you may have regarding MC.

[goofeegirl]

I know this thread is a month old but have to say that I burned out in less than a year working for the MinuteClinic. I don't want to complain about all the reasons why but I am looking for a non-clinical job after working there. The pay and benefits are good but I would rather work for less pay just for peace of mind.

[tnfnp]

I think it depends on what is most important to you- money or a more stimulating job. I interviewed with take care clinics last year and they seemed like they were pretty rigid with their established protocols. I'm curious, what did you decide to do?