Salary vs Productivity Pay

[hutch304]

I'm a new grad NP and had my first interview yesterday. The job is with a private practice physician who sees patients at something like 10+ facilities (inpatient, SNF, ALF, and outpatient in his office too). I really don't know much about the contracts/negotiating/business aspect of this. He offered me a job and gave some options of how I could work with him. One option was salary at $100,000/yr. Another is entirely productivity pay at 70% of billing after overhead. He says there is basically no limit on how many patients that I can see. Benefits seem less than desirable in both scenarios since he is the only provider and there is no 401k or group health insurance rate. I think if I went with the salary option I would ask for productivity bonus. Does either option sound good to start? What else should I ask for in my contract?

[ivanh3]

I am wondering what the demands are if someone is offering a new grad 100K. Ask about the work environment. Being too busy right out of the gate may be frustrating for both you and your patients. This can add a lot of stress. Also ask about what kind of support you are going to get as a new grad. I made sure at my interview to discuss that I was going to be perhaps a bit more "needy" because of my new grad status. The physicians were happy that I was up front about this, and we worked out how consultations with them were going to work (sometimes they were not physically on site). Another area is professional development. Will you get paid time off (above and beyond vacation) and reimbursement (or a budget) for continuing education? For example my first job offered 1 week paid time off and 2000 dollars for CE. Will they cover your Liability Insurance? Will you be taking call? In any case, the devil is in the details. For me the biggest issues was new grad support.

Hope this helps,

Ivan

[JeanettePNP, MSN, RN, NP]

I don't think $100k is out of the ballpark for a new grad, depending on where you're located.

[BostonFNP, APRN]

I'm a new grad NP and had my first interview yesterday. The job is with a private practice physician who sees patients at something like 10+ facilities (inpatient, SNF, ALF, and outpatient in his office too). I really don't know much about the contracts/negotiating/business aspect of this. He offered me a job and gave some options of how I could work with him. One option was salary at $100,000/yr. Another is entirely productivity pay at 70% of billing after overhead. He says there is basically no limit on how many patients that I can see. Benefits seem less than desirable in both scenarios since he is the only provider and there is no 401k or group health insurance rate. I think if I went with the salary option I would ask for productivity bonus. Does either option sound good to start? What else should I ask for in my contract?

As a new grad take the straight salary option or the salary plus productivity bonus (ideal). Your first year of practice you don't want the pressure of having to see more patients than you can handle just so you can make ends meet.

On that note, put some serious consideration into whether this job is the right one for you as a new grad. It doesn't sound like you will have a ton of support which is dangerous in may ways for a new-grad, even one with lots of prior RN experience.

I work on a salary + productivity contract and I make very good money.

[kguill975, MSN, APRN, NP]

I wish I could compare apples to apples for you, but I'll give you my first NP experience. I'm an ACNP/First Assist (dream job) and my first job paid $90K with all licensing, credentialing, Liability Insurance, medical insurance, and CME paid by the employer. I had 3 weeks vacation, plus his 2 weeks vacation that he visits oversees, paid. We operated out of 6 hospitals, and also saw consults and post-ops in 3 additional LTACs, not including the rounding done at the hospitals. I had very little support, other than calling in between hospitals, mainly to get updated lists, in case I missed a new consult in the ER. Operating and rounding into the night, and all I could think about was whether I wanted that life or not. I did it for 10 months, and then left. I was under so much stress and pressure, that I began to hate who I had become. I was impatient with other nurses and patients...stress will do it to the nicest people. While I loved the job, I HATED the job. My quality of life sucked, and I hated my life. When I finally left, I felt that not even $150K a year would be enough. I wish I could tell you that you will have a completely different experience, but I believe that if I had a better support system, and maybe one or two less hospitals to round at, I would have loved that job. Good luck to you, and congratulations on becoming an NP.

[hutch304]

Thank you for the comments thus far. I have a couple more interviews set up for this week in completely different environments (i.e. Primary Care and GI offices) so I'll see how it goes.

[futureeastcoastNP]

I'd say take the salary option. As others have mentioned, as a new grad you don't know how many patients you can see and you want your goal to be learning and taking time, not trying to ensure you make enough money. Also, as others have said, training/support is the biggest question for a new grad NP I would think. I'm sure you are very well prepared but you do need to allow for a transition to independent practice period.

[hutch304]

Thank you for the comments thus far. I have a couple more interviews set up for this week in completely different environments (i.e. Primary Care and GI offices) so I'll see how it goes.

[uronurse1]

My contract is $90,000/yr plus year-end bonus x 2 years and then will switch to lower base pay plus percentage of what i bring in. I am able to really take my time with my patients and become much more comortable in my role before i feel the pressure of meeting productivity goals. Plus i get 6 wks vacation/sick per year, no weekends, no call, and many other perks.

[JeanettePNP, MSN, RN, NP]

To those of you with productivity bonuses: how do you calculate overhead?