Thoughts on these job offers please!

Published

Hi all,

I just graduated my AG-ACNP program, and have these 2 offers on the table. I am in the South.

Job 1

Pain Clinic - working 5 days/week 9-5, expected to see 15-20 patients/day, no procedures. Two other NPs in clinic who will provide training and support, clinic owned by Anesthesiologist. Job approx. 1/2 hour away and I know doctor and staff very well already due to their affiliation with hospital I previously work in.

Salary: $104,000...no benefits of any kind, paid as independent contractor so will have to pay my own taxes, insurance, DEA, etc...

Job 2

Cardiology Clinic - working 5 days/week 8-5, and one weekend/month on call to round at hospital (they said these days are 8-12 and only for rounding). Three Cardiologists and one other NP, orientation and training provided by the physicians. Job approx. 1.5 hours away. Expected to do hospital rounds in the mornings, see patients in the clinic in the afternoons, and also help with consults. In the clinic will be seeing 4-5 patients initially, and once out of orientation and comfortable will be expected to see 8-10/day. Also responsible for supervising stress tests after being trained properly (have to do 150 monitored by cardiologist before doing these alone).

Salary: $85,000

Paid Malpractice Ins.

Licensure reimbursement

CMEs $2000/yr

4 weeks PTO + 13 comp days for weekend rounds

401K with matching

Health Insurance (tier plan)

Job 1 I am in the process of negotiating, Job 2 I was told is handled by the hospital's HR and negotiation is unlikely.

What are your thoughts?

Thanks

core0

1,828 Posts

Hi all,

I just graduated my AG-ACNP program, and have these 2 offers on the table. I am in the South.

Job 1

Pain Clinic - working 5 days/week 9-5, expected to see 15-20 patients/day, no procedures. Two other NPs in clinic who will provide training and support, clinic owned by Anesthesiologist. Job approx. 1/2 hour away and I know doctor and staff very well already due to their affiliation with hospital I previously work in.

Salary: $104,000...no benefits of any kind, paid as independent contractor so will have to pay my own taxes, insurance, DEA, etc...

Job 2

Cardiology Clinic - working 5 days/week 8-5, and one weekend/month on call to round at hospital (they said these days are 8-12 and only for rounding). Three Cardiologists and one other NP, orientation and training provided by the physicians. Job approx. 1.5 hours away. Expected to do hospital rounds in the mornings, see patients in the clinic in the afternoons, and also help with consults. In the clinic will be seeing 4-5 patients initially, and once out of orientation and comfortable will be expected to see 8-10/day. Also responsible for supervising stress tests after being trained properly (have to do 150 monitored by cardiologist before doing these alone).

Salary: $85,000

Paid Malpractice Ins.

Licensure reimbursement

CMEs $2000/yr

4 weeks PTO + 13 comp days for weekend rounds

401K with matching

Health Insurance (tier plan)

Job 1 I am in the process of negotiating, Job 2 I was told is handled by the hospital's HR and negotiation is unlikely.

What are your thoughts?

Thanks

I'll point out the the money for the second is probably more than the first. If you look at the self-employment taxes alone you are looking at $96000 for the first job (in a W2 job they take out around 7.5% for SS and Medicare - for 1099 you have to pay the whole 15% or $8000). Toss in malpractice 401K and health insurance an you are probably looking at less than $85k. There are tax deductions for 1099 but I doubt they make up for the other issues. On the other hand 3 hours in the care each day isn't worth it for me.

Career Columnist / Author

Nurse Beth, MSN

167 Articles; 2,963 Posts

Specializes in Tele, ICU, Staff Development. Has 30 years experience.
Hi all,

I just graduated my AG-ACNP program, and have these 2 offers on the table. I am in the South.

Job 1

Pain Clinic - working 5 days/week 9-5, expected to see 15-20 patients/day, no procedures. Two other NPs in clinic who will provide training and support, clinic owned by Anesthesiologist. Job approx. 1/2 hour away and I know doctor and staff very well already due to their affiliation with hospital I previously work in.

Salary: $104,000...no benefits of any kind, paid as independent contractor so will have to pay my own taxes, insurance, DEA, etc...

Job 2

Cardiology Clinic - working 5 days/week 8-5, and one weekend/month on call to round at hospital (they said these days are 8-12 and only for rounding). Three Cardiologists and one other NP, orientation and training provided by the physicians. Job approx. 1.5 hours away. Expected to do hospital rounds in the mornings, see patients in the clinic in the afternoons, and also help with consults. In the clinic will be seeing 4-5 patients initially, and once out of orientation and comfortable will be expected to see 8-10/day. Also responsible for supervising stress tests after being trained properly (have to do 150 monitored by cardiologist before doing these alone).

Salary: $85,000

Paid Malpractice Ins.

Licensure reimbursement

CMEs $2000/yr

4 weeks PTO + 13 comp days for weekend rounds

401K with matching

Health Insurance (tier plan)

Job 1 I am in the process of negotiating, Job 2 I was told is handled by the hospital's HR and negotiation is unlikely.

What are your thoughts?

Thanks

The terms of the second are much better, and more importantly, you will have much more opportunity to increase your skills.

Advanced Practice Columnist / Guide

juan de la cruz, MSN, RN, NP

9 Articles; 4,338 Posts

Specializes in APRN, Adult Critical Care, General Cardiology. Has 31 years experience.

I have to agree with the previous posters. Job 2 actually has a better compensation package and it's a role that's more aligned to your AG-ACNP training. What do you think of the commute for job 2? That long commute would be a deal breaker for me as someone who lives in a busy metro area where many people actually spend 3 hours stuck in traffic for their daily ride back and forth to work.

prelift

73 Posts

second job. most places in the south arent a bad commute unless your in atlanta or some huge city.

allnurses Guide

BCgradnurse, MSN, RN, NP

1 Article; 1,678 Posts

Specializes in allergy and asthma, urgent care. Has 14 years experience.

The second job has better overall compensation, but the commute is pretty long. That being said, I don't think there is enough money in the world to get me to do pain mgmt, especially if you can't do procedures. I see that as a fast burn out job. Can you move any closer to the cardiology job?

Has 12 years experience.

core0, thanks so much for your time and response. I figured the 2nd job was a better deal but like you said 3 hours is a long commute. I have time to make a decision with both jobs so I am still job hunting in the meantime.

Has 12 years experience.

Nurse Beth, thanks for your time and response. I agree that the second job would be a better opportunity for growth. If it wasn't a 3 hour roundtrip commute, it would be a no brainer. Hopefully I can find something closer.

Has 12 years experience.

juan de la cruz, the commute is the only thing that's bothering me about job 2. The drive isn't bad as far as traffic, it's a long highway stretch with minimal traffic, the distance and time however is an issue. I have a lot to think about. Thanks for responding.

Has 12 years experience.

prelift, you're right. I live in the deep south and although it's a long commute, it's a highway stretch with minimal traffic. Thanks for responding.

Has 12 years experience.

BCgradnurse, I wish I could but we just built a house. I really am intrigued with the cardiology job though. It's more of what I imagined myself doing when I decided to go back to NP school. I also like that they were able to lay out in detail the orientation and training I'd be getting. Seems like such a good opportunity and environment to learn and grow. Thanks :)

bbcewalters, NP

178 Posts

Specializes in NP, ICU, ED, Pre-op. Has 12 years experience.

Although I think the 2nd job is better overall, if you had to take the first job most pain management jobs run by anesthesiologists are not pill mills and are usually very focused on procedures. Even though you state no procedures is this something they could train you for in the future to make the job more desirable? You can actually learn alot in the pain management world because you have to understand how all the other disease processes work with the potential meds you will be prescribiing. While it may not be ideal, you can use it as a stepping ground. Just thoughts from the other side :)