any PNPs out there??

squinky12 · Sep 12, 2008

I have continued to think about this and have a few more thoughts (I am a math geek so bear with me):

If your friend is earning 120K per year then this works out to slightly more than $2300 per week. If this is based on seeing 300 patients per week (100 per day for 3 days per week) then she is making $7.69 per patient seen.

In our office, I work on a percentage based on the amount of money I bring in to the practice. This is good because it shows the total amount I bring in and I have a computer log of all patients I see.

Once you have this figures the possibilities are endless...

As a math geek :imbar I did some statistics based on my earnings over a 3 year period and learned that I made approximately $18 per patient seen on the average. This is a mix of payors and a mix of sick and well visits and includes some inevitable write offs that occur when accounts go to collections. Surprisingly, Medicaid and CHIP pay more than many of the private insurers for the same service.

During the same 3 year period I saw an average of 28 patients per day and worked a total of 47 weeks (not paid for vacation time, sick days etc. So, this comes to an annual salary of $118,000 per year which is pretty close to what is being offered to your friend.

In her case, assuming anyone could consistently see 8 patients per hour, they should make $144 per hour so working 36 hours per week should yield $5184 per week/$269568 per year which is more than double what she is being offered. Hmmmm---someone is making a whole bunch of $$ here and your friend is only receiving a small percentage of that. Of course, paying for her lodging and whatever other benefits are provided would also have to be taken into consideration.

Hope nobody's eyes glaze over when reading this:D

ANPFNPGNP · Sep 12, 2008

100 pts per 12 hours is 8 pts per hour. Thats one patient for seven minutes. If you have a lot of rooms and an efficient office you could do this for minor complaints. One of the FPs I trained with had 5 minute appts for minor problems (ie cough cold etc). Of course this was never the whole problem. At least kids are a little less complicated. If this is 100 "simple" problems ie a 99212 then this is possible. If this is 100 "complete physicals" then yeah its fraud. BTW 100 99212's is around $4000 per day. Not bad money.
David Carpenter, PA-C

These are kids, so there are pretty simple, but you can still miss something. 100 pts in 12 hours is absolutely outrageous, even for "simple" complaints.

One day I saw 70 pts in 9 hours at the UC clinic. Most of the patients were Workman's Comp followups and thankfully I didn't have any I&D's or suturing thrown in there. I called the doctor and informed him that I would never see that many patients again b/c it was dangerous. He laughed and told me that he could see a patient EVERY FOUR MINUTES! I refused to work at that clinic again. Usually, I'll see 40-50 pts AT THE MOST in a 12 hour period at an UC clinic. At my other job, I'm overwhelmed if I see more than 20 pts in an 8 hour period b/c of the complexity of the problems.

Something else, a doctor told me that he was working in an urgent care clinic when he was a resident and he saw 65 pts in 12 hours. He saw a child with strep throat with generalized abdominal pain. He focused on treating the strep throat and sent the kid home. The kid had a ruptured appendix and almost died the next day. He swore he would NEVER see that many patients again, even in a minor emergency setting.

Doctors are abusing the heck out of midlevels...it's all about seeing more patients and making more money. I think a doctor should only be able to supervise ONE midlevel and that's it.

ANPFNPGNP · Sep 14, 2008

I have continued to think about this and have a few more thoughts (I am a math geek so bear with me):
If your friend is earning 120K per year then this works out to slightly more than $2300 per week. If this is based on seeing 300 patients per week (100 per day for 3 days per week) then she is making $7.69 per patient seen.
In our office, I work on a percentage based on the amount of money I bring in to the practice. This is good because it shows the total amount I bring in and I have a computer log of all patients I see.
Once you have this figures the possibilities are endless...
As a math geek :imbar I did some statistics based on my earnings over a 3 year period and learned that I made approximately $18 per patient seen on the average. This is a mix of payors and a mix of sick and well visits and includes some inevitable write offs that occur when accounts go to collections. Surprisingly, Medicaid and CHIP pay more than many of the private insurers for the same service.
During the same 3 year period I saw an average of 28 patients per day and worked a total of 47 weeks (not paid for vacation time, sick days etc. So, this comes to an annual salary of $118,000 per year which is pretty close to what is being offered to your friend.
In her case, assuming anyone could consistently see 8 patients per hour, they should make $144 per hour so working 36 hours per week should yield $5184 per week/$269568 per year which is more than double what she is being offered. Hmmmm---someone is making a whole bunch of $$ here and your friend is only receiving a small percentage of that. Of course, paying for her lodging and whatever other benefits are provided would also have to be taken into consideration.
Hope nobody's eyes glaze over when reading this:D

Yeah, the one who's making all the dough is the DOCTOR - as usual!

One of the docs I work for found out that another doctor was paying his NP a percentage of what she brought in. He was outraged and told the NP's boss to warn her to NOT let anyone know she was getting a percentage b/c then we would ALL expect that!

I'm still hoping for independent practice. I'm sick and tired of making all these doctors money when I'm the one doing all the work!

squinky12 · Sep 14, 2008

I guess I am just really lucky because I have a great situation and have always been treated well--I really like and respect the docs I work with and I was their first NP. Our second NP was a new grad 2 years ago and was actually my student for a semester. She does a lot more "consulting" than I do and is still on a salary type situation but is also treated well.

In the past, I have had a couple of HORRIBLE jobs but never for long because I am not the "suffer in silence" type. The worst was a "med-ped" who could not understand why I would need longer than 10 minutes to see any patient AND wanted me to see some of his adult PHEN-FEN patients for him (no way) when I was not busy (and we all know how THAT turned out).

ANPFNPGNP · Sep 14, 2008

In the past, I have had a couple of HORRIBLE jobs but never for long because I am not the "suffer in silence" type. The worst was a "med-ped" who could not understand why I would need longer than 10 minutes to see any patient AND wanted me to see some of his adult PHEN-FEN patients for him (no way) when I was not busy (and we all know how THAT turned out).

My first job was with a pain management doctor. I made a TON of money - $20/pt just for refilling their narcotics (sometimes saw 50 pts per day). Basically, I was a drug dealer with a pen. After a while, I caught on to the fact that half these patients didn't need these drugs and I got out of there. Needless to say, this doctor is being investigated by the Board of Medicine (he's also been kicked off a couple of major insurance plans).

I think the whole "prescription weight loss" gig is a lot like the "pain management" gig...totally unethical and dangerous to the patients in the long run.