Putting the feelers out

[Mr. Southern NP, MSN, APRN, NP]

So I've been testing the waters to see which of the local nephrologist groups might be interested in hiring a nurse practitioner early next year (I graduate with my MSN/FNP in December). Pretty much every group has told me I won't have any trouble finding a position right away, with only two of the groups showing actual interest. The issue I have concern with is: both the practices showing interest are smaller (one physician and one NP at one, and only one physician at the other) and both have their wives working as the practice/office managers. I have spoken at length with the new NP at the practice with 1 MD and 1 NP. She has no nephrology or dialysis experience and started at 95k. I have 2 years CVICU experience followed by 8 years of in-center hemodialysis experience. I have heard from several people at all levels that it is not advisable to work at practices that use spouses/family for practice/office managers. I take pretty much all advice with a grain of salt, but this advice has been fairly consistent.

So what I would like find out from those with experience is:

Is it all that bad to work at a small practice as described above?

There is one larger group practice that I am interested in but have not spoken with yet that has 4 MDs 2 NPs and 1 PA. I have a good working relationship with the providers this practice and would likely be able at the very least get an interview with them. I am pretty confident that I can sell my experience and skillset in order to obtain a position as well.

Any friendly advice for a soon-to-become NP would be appreciated. Thanks in advance.

[fsuao2006]

Although I do not have personal experience working in a clinic, my best friend did. She worked in a clinic as a rad tech, husband was the MD and wife was "office manager" she said this was a toxic environment, they were always fighting. The wife had no medical or management experience yet she liked to go around telling everyone what to do. Long story short, she left this practice and has happily found a job in a hospital. They later got divorced.

I also personally grew up in an environment where my mom was the office manager to my step-fathers practice. Let me tell you, this wasn't ideal. Other employees had problems with this arrangement and if there was ever a problem at home it was brought into the office. I would continue to look elsewhere for a position where your skills will be utilized and there is a better chance for a healthy workplace.

[traumaRUs, MSN, APRN]

I agree with above - small practices where spouses work together might not be a positive place.

I personally would choose the larger practice. They are probably (hopefully?) on point with good business practices and can utilize you to the fullest extent of your state's practice act.

A larger practice also is hopefully growing and will provide more opportunities.

Let us know what you choose.

[espress099]

I agree. i had several clinicals at places where the wife was the office manager- always a toxic environment. I have yet to see it work out well. I was one of the deal breakers for me when i was looking for work. i'd keep looking if I were you. Or you could talk to the office staff when you interview and see what they think about it/how it works (or doesn't work) there.

[Mr. Southern NP, MSN, APRN, NP]

Thank you all for your input. That is the general consensus I have heard from those around me. I will likely pursue the larger practice. I will begin reaching out to them more definitively beginning this fall with the hope of being able to interview sometime shortly before or after graduation. As is said before, I have a good rapport with all the providers in the group and even some of The office staff. Thanks again for everyone's two cents. I’ll keep the community up to date with how everything turns out.