Thoughts on these job offers please!

core0 · Jun 11, 2017

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 · Jun 11, 2017

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 · Jun 11, 2017

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 · Jun 11, 2017

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

allnurses Guide · Jun 11, 2017

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?

Freedomsong, NP · Jun 11, 2017

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.

Freedomsong, NP · Jun 11, 2017

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.

Freedomsong, NP · Jun 11, 2017

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.

Freedomsong, NP · Jun 11, 2017

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.

Freedomsong, NP · Jun 11, 2017

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 · Jun 11, 2017

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 :)