GuestNP

I am so glad I only own and operate cash pay practices. This type of policy change and debate does not even affect me. I think NP's should be compensated for equal work. At the end of the day it is about how much your produce for a specific practice. If the NP sees more patients and bills out more, then they should be compensated fairly. Most MDs will go the way of specializing in the future and us NPs will do primary care, urgent care, a large chunk of ER work, and basic hospitalist duties. Let them have the specialties and make the big bucks. Let us have general practice with fair compensation.

Oh, socialist California how I love you ? What kind of non sense is this? Is this not a FREE country?

You are totally right. MD's have much more training than a NP. No question. This is not an argument. Our point is that many straightforward fields do not require MD training. General primary care is simple for the most part. Sure there are complicated cases and you better know when to refer out or not. I knew a MD in primary care who did NOTHING. He referred everything out, and I mean EVERYTHING. He was lazy. I also know many MDs who stopped practicing in the ER to open a Suboxone clinic. They did nothing more than take a class, just as much as we can. There are some fields that are simple and easily learned. Most NPs are not looking to take over specialist or surgeon jobs. Screw that. We are not prepared for that by any stretch of the imagination. A NP who does something very simple such as suboxone, aesthetics, testosterone replacement, weight loss, etc... and is just one hell of a business minded individual. That person like any entrepreneur can become a millionaire and it did not require a 6 year orthopedic residency. This is reality. I agree with everything you said. Sometimes its better to meet the middle ground and get something a little easier for less money and less liability. Don't push your limits.

Starting a business is simple. Create a LLC, find a niche service, market it, and go. There really is nothing to it. I am located in the southwest. I work in an independent practice state. It is the only way to practice.

Highest paid specialty? Own your own business. Enough said. You can make tens of thousands a month passively owning multiple part time practices and businesses. It is what I do and what I advocate for. If you do not wish to start your own practice, then urgent care with a production base salary. I make $180k a year working 3 days a week at a busy urgent care. You work for it though.

It really depends on where you will be working. Taking procedural classes is always a good idea. Most NP's coming directly out of school feel ill prepared with their education and training. Whatever field you are about to enter, buy medical school grade books and guidelines and really digest this information. This will put you light years ahead of any other new grad NP. I know, I did so.

It should be at least 20-30% more than your full time base rate. You could even negotiate higher than that depending on how desperate they are. I have negotiated PRN 1099 contract rates as high as $100 an hour. If you go this route, ensure you are being paid 1099 to a LLC. This is the most tax advantageous route to take. The goal with a 1099 position is to legally avoid as many taxes as possible and the best way to do this is having it paid to your LLC for business expenses.

Don't cut yourself short. You have plenty of clinical experience. You just don't have experience in the things you are trying to pursue. It is time to buy some books and guidelines and dive deep into them. Follow the guidelines, it is not difficult. Have you considered opening your own business? That is where the real money and freedom is!