Rural Health

Editorial Team / Admin · Jan 25, 2006

Anyone in Rural Health Facility or HPSA? I am considering moving to this arena for loan repayment purposes and would like to hear from someone already in it. What's the situation, how are the hours, call, compensation, benes, patient load....etc etc...???

Hello, cgfnp,

I have been in a rural health clinic for over 10 years now.

I know of one NP who is working in the system for the loan repayment issue/s, too.

I am considered full time and work 3 days a week. But, the drawback for me is the clinic is 2 hours one way drive. I stay down there 2 nights a week. Breaks it up a bit. I also relieve NPs around my state in rural health clinics, free-standing and/or hospital owned.

My (long) hours vary. Depends on my patient load. I also take ER call as the sole HCP. Pay is great. Benefits good. Retirement, health insurance, profit sharing, incentive bonus, etc. All this will depend upon the clinic/hospital hiring you.

brownrice · Jan 26, 2006

Hi Cgfnp:

If I remember right, you are practicing in the Tucson area and had obtained a very lucrative practice position with a friend/MD. I wonder why you are looking at working perhaps in an HRSA cotact for loan payback? From what I understand, clinics and positions funded through this contract usually don't pay as well as private clinics. Wouldn't the pay cut vs. getting the loan payback dollars kind of even itself out?

I do know that loan payback and higher salary can by found with IHS contracts on the reservation, e.g., Navajo in Tuba City. I did a BSN clinical rotation there. Would be a difficult place to live however. I deemed it much, much, worse than the Marine base in Yuma.

I am in Washington State now, studying to be an FNP. I miss Tucson and all my favorite restaurants there!

Editorial Team / Admin · Jan 26, 2006

Hi, brownrice. The rural health clinic set up with the Federal government will completely pay for the education as NP. Will usually require a 3 year contract. That payoff will save TONS of money in the long run. And, that is a sweet deal all the way around. And, the salary at a rural health clinic can be as sweet.

cgfnp · Jan 26, 2006

Hi Cgfnp:
If I remember right, you are practicing in the Tucson area and had obtained a very lucrative practice position with a friend/MD. I wonder why you are looking at working perhaps in an HRSA cotact for loan payback? From what I understand, clinics and positions funded through this contract usually don't pay as well as private clinics. Wouldn't the pay cut vs. getting the loan payback dollars kind of even itself out?
I do know that loan payback and higher salary can by found with IHS contracts on the reservation, e.g., Navajo in Tuba City. I did a BSN clinical rotation there. Would be a difficult place to live however. I deemed it much, much, worse than the Marine base in Yuma.
I am in Washington State now, studying to be an FNP. I miss Tucson and all my favorite restaurants there!

I'm not in Tucson any more... moved back home to Missouri after going to Tucson for school. I do have a pretty sweet deal w/ my MD friend, but money isn't everything, and there are many other factors that are influencing my decision. I will have to take somewhat of a paycut, but with benefits (which I have none) and loan repayment, it'll all pretty much wash out in the end. And, as Siri mentioned, even in (and actually especially in) rural health clinics you can do just fine with the $$$. In Missouri, as I'm sure in most states, the reimbursement for gov't insurance is higher in rural health clinics, so the revenue generating potential of a NP is actually higher in a rural health clinic than other primary care clinics. If there's more money on the table at the end of the day, I would think you would be able to negotiate for higher salary. I certainly hope they see it that way! :uhoh21:

brownrice · Jan 26, 2006

Hmmm, I see! The example from home here in the NW is such: the local Community Health Clinic here starts new grad NP's/PA's at about 55,000. Payback is full time work over 2 years, up to 50,000 of student loans. Benefits seem very standard: basic medical, dental, optical.

btw, are you missing AZ yet?

Editorial Team / Admin · Jan 26, 2006

Is your Community Health Clinic a rural health clinic, brownrice? Just wondering.

brownrice · Jan 26, 2006

It is not out in the boonies, it is within a city of 40,000. However, it serves a large, rural area which surrounds it. Migrant folks (80% of the patient base) come from 20 minutes to approx 2 hours away to visit this clinic, as there is no other closer clinic for them to visit.

elkpark · Jan 26, 2006

Although I'm not in that situation myself, I have had two friends who did it -- one a PNP, and one a family practice MD. The PNP works in a clinic in a small town up the Hudson River from NYC -- it counts as a "rural" location, and is a v. economically depressed area, but is just a short train ride from downtown Manhattan. I've visited, and it's a lovely, peaceful area to live in. The MD went to a clinic on a Native American reservation in AZ (very rural).

Both individuals got all their school loans paid off, and both individuals enjoyed their jobs so much that they have both stayed with the same organizations even though they completed their obligations many years ago, so you can assume that they were satisfied with the experience!

cgfnp · Jan 26, 2006

Hmmm, I see! The example from home here in the NW is such: the local Community Health Clinic here starts new grad NP's/PA's at about 55,000. Payback is full time work over 2 years, up to 50,000 of student loans. Benefits seem very standard: basic medical, dental, optical.
btw, are you missing AZ yet?

I've seen the offers from WA, and they are pretty similar across the US. They are reluctant to offer big bucks 'site-unseen' which is understandable. As far as they know, I may be 'booked' with 8 patients/day.

I don't miss Tucson... too hot, no grass or trees.

brownrice · Jan 26, 2006

I know this clinic will cram in as many patients as they think a provider can humanly handle. I know people that work there now. So, you think the 55,000 is more like a baseline starting point?

cgfnp · Jan 26, 2006

I know this clinic will cram in as many patients as they think a provider can humanly handle. I know people that work there now. So, you think the 55,000 is more like a baseline starting point?

Yeah, and also a test to see if they will keep working for that. If they will, then more money for the administration. If they are smart, they will know the numbers and use them to renegotiate.