I know this has been a thread before, but let's have an updated conversation now that we are in 2017. I am posting this as I am a soon-to-graduate NP student and because I am a female. Nursing is still a female-dominated profession and I would like to empower other NPs (both male and female) to better negotiate and claim their professional worth. I believe one way to do this is by sharing information. Lets do this!
Why wouldn't it? You have to think like a doc and not like a nurse re salary. You also have to be willing to walk. I have been offered much lower compensation a number of times - I just said "thanks but no thanks". I am good at what I do and will not accept low pay. If you are good and you know what you want and are willing to walk if you don't get it then you will be more successful when it comes to increasing your compensation.
I agree. I am a new grad and happy to have a guaranteed salary. I expect to be making 65,000ish extra with my productivity. But if I knew my numbers I would negotiate a higher salary. Even as a new grad, I know I'm competent and I know I will generate a lot of profit for my employer. My intent is to track my billing and negotiate a much better contract in two years. But for now I feel I was offered a fair salary and benefits. But.... you'll never get paid well if you don't believe you deserve to be paid well. The market may be saturated with FNP but it is bleeding and dying for primary care providers. MDs are no longer choosing primary care as a specialty. Look around at the clinics, the MDs are all well over 60 in most places. They need us to fill that gap. I have never heard we have too many PCPs. Stop thinking of yourself as an NP and start thinking of yourself as a PCP.
Ok, but my question is: do I negotiate the higher salary after accepting the position and showing my worth, or do I do so initially after they make me an offer, TELLING them about my worth and what I can bill and bring into the practice? Everyone thinks they high to accept what the average for their area is. Here in southern Connecticut, where the cost of living is high, its not much more than 100k. I started at 108k and that was one of the highest in my graduating class. I really would like to make over $200k like you, or more accurately, make that and work 3/4 time and make 175k.
One last question: does the bargaining chip of 85% only work with private doctor practices? I would imagine so, as most place like hospital urgent care centers that I have worked for, offer a salary to all NPs and it doesn't vary and then you get paid a little bit on productivity. The UC I work for offers 85 an hour per diem, which isn't bad. But I'd like to make that or more with BENEFITS. All the hospitals say "this is what we offer to NPs with your amount of experience". So-=-only private internal med/specialty offices can be swayed to offer 200k?
Ok, but my question is: do I negotiate the higher salary after accepting the position and showing my worth, or do I do so initially after they make me an offer, TELLING them about my worth and what I can bill and bring into the practice? Everyone thinks they high to accept what the average for their area is. Here in southern Connecticut, where the cost of living is high, its not much more than 100k. I started at 108k and that was one of the highest in my graduating class. I really would like to make over $200k like you, or more accurately, make that and work 3/4 time and make 175k.
One last question: does the bargaining chip of 85% only work with private doctor practices? I would imagine so, as most place like hospital urgent care centers that I have worked for, offer a salary to all NPs and it doesn't vary and then you get paid a little bit on productivity. The UC I work for offers 85 an hour per diem, which isn't bad. But I'd like to make that or more with BENEFITS. All the hospitals say "this is what we offer to NPs with your amount of experience". So-=-only private internal med/specialty offices can be swayed to offer 200k?
You ask for what you want when you are offered a position. Do not wait until after you start. I asked for 40 thousand more than I was willing to accept in guaranteed salary and then I asked for 5 percent more than I was willing to accept in profit bonuses. They countered at just about exactly my lowest "willing to accept salary" but they threw in all kinds of extra's. I am not working full time, I got 40,000 towards my student loans, I make my own schedule, etc... Also, make sure you are afforded the same ancillary staff an MD is. Never accept a job where they expect you to do RN duties as well. Ultimately, a base salary is just that. If you are productive you should make much of your money from your billing. Like I said, my base is 100,000k but I expect to make 65,000ish off of RVU bonuses. I came into negotiating with an attitude that I am worth it because I am. They make the same amount of money billing for you as they do an MD. So, you should make money too. Nonetheless, don't show up empty handed with "I want to make this because it's what I want." I made a portfolio, I told them why I was competent. I took record of the kind of patients I saw as a student, how many I saw a day (with a preceptor having to follow my exam), what procedures I did, etc... and I told them if my productivity looks like it did when I was a student and you pay me X you will still profit X from my billing. Know your stuff. You can also sell the longevity thing. "I am looking for a practice home to spend my entire career with where I develop professional and patient relationships." Your institution will gain a lifelong employee if you invest in me upfront. This will save you training costs, turnover costs, patients who may leave if I leave, etc... I understand being anxious. I was too, and there was not thread like this when I negotiated months ago. But I decided, if I had to I could take a per diem job that paid until someone was ready to pay me what I was worth. It will work out. Just draw it up, type it up, practice your negotiating in front of the mirror. Make it happen.
You're always in a stronger position before you say yes. $85 per hour isn't bad. That's over $170k per yr. I would take that and later look to earn that or more with benefits.
OK. and I have over 2 years of experience as an NP as well. I also have 5 years of RN experience before that in the ED. Hopefully that helps. So I can go in asking for 175k?? I know in my practice, the IM docs start at 208k, and we are a part of a huge Catholic nationwide healthcare organization, which owns our hospital that has a Multi specialty group with several practices.
So you're a brand new grad and negotiated 108k and what is the RVU structure like? It is family medicine? How did you do the portfolio and how would I do the portfolio with my current practice? The problem is we aren't busy here. I COULD see a lot of patients and I do a lot of procedures too, as I'm in urgent care as well, but we don't have the volume here. If the volume was here, I could easily handle it
Also, a large hospital gave you student loan repayment? Where are you located? No one offers that here. Was that something that they weren't offering but then gave you for a certain amount of service?
Yes I am brand new. I hadn't even tested or become licensed when I was hired. I expect to see approximately 15-20 patients a day (mostly 20, maybe more if I like), do a few procedures here and there, and my RVU bonus is $30/wRVU over the median I produce. If I were seeing what I saw as a student (which I expect to see more) I would make about 40k above my guaranteed salary of 100k. But we do have the volume. The clinic I am at is bursting at the seams. Also, in my state NPs just got the go ahead to do in office vasectomies. So, I am doing CME and working with a provider in the office who does them to get a certification. He is going to retire soon enough and I will probably pick those up. Those bill very nicely.
Also, a large hospital gave you student loan repayment? Where are you located? No one offers that here. Was that something that they weren't offering but then gave you for a certain amount of service?
Yes, they did. 40,000 over two years. They area national company too. They have hospitals and clinics in 6 states. It is not a government payback kind of situation. It is from them. We do not have a provider shortage where I am from. We have two medical schools here and three NP schools.
Wow! What state? You're in urology then, since you're doing vasectomies?
Oregon. Nope, not urology, family practice. Old school MDs in family practice still do vasectomies here and FNP scope in Oregon allows it. I am not doing them yet, I am working on getting CME, assisting the provider, then doing supervised practice, then certification. It will be a while, 1 or more years until I'll be ready for vasectomies, but once I am that will add a lot to what I bill.
nursenikki1010
18 Posts
I agree. I am a new grad and happy to have a guaranteed salary. I expect to be making 65,000ish extra with my productivity. But if I knew my numbers I would negotiate a higher salary. Even as a new grad, I know I'm competent and I know I will generate a lot of profit for my employer. My intent is to track my billing and negotiate a much better contract in two years. But for now I feel I was offered a fair salary and benefits. But.... you'll never get paid well if you don't believe you deserve to be paid well. The market may be saturated with FNP but it is bleeding and dying for primary care providers. MDs are no longer choosing primary care as a specialty. Look around at the clinics, the MDs are all well over 60 in most places. They need us to fill that gap. I have never heard we have too many PCPs. Stop thinking of yourself as an NP and start thinking of yourself as a PCP.