Osorry1

This is a copy of what the thread looks like on the Nurse Practitioner section. Only a few threads down from your own. NP productivity info? overworkedNP 05-16-2005 05:58 AM by spaniel 4 132

See the NP productivity post where we dicsuss these issues.

Thanks for the info. Do most of the NPs in your area get production bonuses like this? I work in a private family practice with 4 physicians who are partners who own the practice, and then there are a total of 2 NPs. Both of us NPs are getting very frustrated because of the long hours we are working and the amount of patients we are having to see. We are on salary so it is not benefiting us at all when we work 50 or more hours per week and we are getting burnt out fast. I have been there for 6 years now and have built up quite a patient base. Every month we get our productivity numbers and also it tallies up monthly until end of year. last year i billed out 432,000. and only got a 3,000 raise, the year before was around 398,00 and i got a 2000 dollar raise. they dont really go according to our productivity at all when determing anything and so we are both wondering why in the world we are doing this and working so much for us to not get any benefit from it. The partners split the earnings at the end of the year according to their productivity as well as their salary, but we are not receiving anything at all other than just a salary which is around 70k presently. They say it is what an average np salary is and that we should not complain and that the benefits are good. which they are okay, but are the same as most other nps. We NPs there see approx 30-45 patients per day and while we close at 5, we are usually there until around 7 because of all the walk-ins, which we are expected to see until there are no more left. They say these visits are the businesses "Bread and butter". Did they offer this bonus toyou or did you present it to them? any advice on how i can convince them to pay us by productivity? thanks for your input. I know of some NPs that are paid salary and production, it's likely we are the exceptions. The productivity option was part of my employment offer, and they say that other NPs before me had this same salary. My contention has always been that if insurances are paying us 80% of what MDs make, then my salary should be about 80% of theirs. I know this is naive, but the CEO actually admitted the financial advantage to companies to having NPs on lower salaries as the companies absorb the difference in the 80% of what we're reimbursed - the paltry salaries they may pay us. I've also used this strategy with the CEO to get nice salary increases the 2 years I've been here (over 5K each time). And we all work 8-5pm and usually no more, but when do go over, that counts in our productivity. We're currently reviewing potential changes in our company and moving to straight salary, which will be set by current salary plus bonuses for past years, so I'll still do ok should they change to that. My suggestion would be to find you total costs to the firm- salary, benefits, your percetage of office overhead, then compare that to your production and your salary. Offer to negotiate for a larger percentage of your overage, showing them the numbers (currently as a provider with no bonus, the partners are reaping the dollars from your excess labor) or suggest a buy in as a partner for a certain percentage of bonus based on the buy in amount. We actually had a class in school that worked with us on these numbers and negotiation, which many MDs don't learn until they're out working. It bored us at the time, but we appreciate it now.

I went to Vanderbilt, and am now working as an NP. Yes, it's worth the money, the time, and all the hard work that is required to complete 3 years worth of studies in 6 semesters. I'm now completing loan repayment through NHSC to cover loan costs. I'd do it again in a heartbeat. Being a Vandy grad didn't hurt in the job hunt either.

At our facility, we (NPs and MDs) are paid salary plus productivity bonus. They figure out overhead and other fees that equal our salary, benefits, etc. Based on what we cost them per 6 months they give us 70% of out over production back each quarter. Example: If I worked 1025 hours from 7/1/04-12/31/04 ( I'm taking these numbers from my last production report)- I was expected to generate 182K in revenue for the company (hours worked times what they figure I cost them as an employee). I generated 209K in revenue for the company for a total over production of 26K. The company gets 30% of the 26K, I get 70% as bonus (18K before taxes). That is one example.

I had some friends in my class that had been OR RNs or connections with surgeons, etc. before NP school and they were working as first assists in cardio, neuro, and ortho that I know of, so I know they are out there. You may need to try to first qualify for OR nursing, then after returning to school (in an acute care NP program) get advise from professors about how you can arrange a rotation for that kind of training. It is possible. It is out there. Hope this helps.

See answers to your questions above.

I graduated from Vanderbilt and every year more male students are applying and being admitted. Right now, it's around 10+%, equal to that of minority NP students. There are several male NP faculty at Vandy for mentors and encouragement. Good luck!

Salaries vary based on area of the country, experince, etc. but in general, most starting NPs earn at least 60-65K per year (national average). Many NPs make significantly more. http://www.advancefornp.com has a very good salary survey that can guide you. Also many people, like myself, choose to work in health care shortage areas so the government will pay back your loans. That's also an added advantage and should be considered in your decision.

Hello, I'm a Psych NP in a community mental health center with 6 other psychiatrists. It's a great job, and always a different challenge. I work well with the other psychiatrists, we consult together about tough cases, their asking my thoughts almost as much as my asking their input. We all share the same types of patients, actually, I'm frequently given some of the more chronic, challenging patients when they leave the inpatient hospital, because the inpatient psychaitrists says "I'll follow them better and make sure they're getting the services and encoruagement they need." My schedule is a somewhat less than theirs as I've only been here a year, so slowly building the numbers. I cover for the inpatient doctor when she's on vacation as well. So, except for the paycheck (which they've tried to make as attractive as many of my NP colleagues), my duties, acceptance and activities at the center are equivalent.

There should be a phone number to call NHSC for verification, 1-800-221-9393 from 9 a.m. to 8 p.m. EST or e-mail [email protected] according to their website. I believe this is likely an error, although they do require you to work as an FNP for the NHSC scholarship. These loans are pretty competitive. For the scholarship program, only FNPs are allowed. I am a Psych NP and applied after graduation for the NHSC loan repayment program, and was awarded this fairly quickly. There is somewhat less competition recently, and the earlier you apply the more likely you are to be awarded loan repayment.

On the patients I had with elevated Prolactin, I just switched meds or switched to injectable Risperdal (liver metabolism increases risk of prolactin elevations) without problems or recurrence of psychosis.

Yes, I had worked as a psychotherapist for 10 years before going back to school to complete a Psych NP program. Many states are now specifying that your degree is in your specialty area (psych, geri, acute, etc.). Also don't let not having RN experience deter you from pursuing the degree. You may see some on this site say you need to work as an RN first, but that isn't always the case, and many jobs will hire you without that experience, as the NP and RN positions are different. You can review the http://www.vanderbilt.edu/nursing site for more info on the psych program

I've been in practice for a year and I've had 2 females lactate, 2 go ammenorheac on me, and 1 male with starter breasts. Highest dose used was 3 mg bid. Now I monitor before and during treatment prolactins when I check for other labs- glucose and cholesterol.