Waiting on my 85%

[TX RN]

So in working at an adult internal medicine clinic, over the past 6 months the following has become quite clear:

1. I see the majority of patients and take ALL the triage calls.

On average see 5 for every 1 pt's the doc sees.

2. I receive about a 1/3 of the compensation that the doc makes.

3. My outcomes so far have been (knock on wood) great! As good as the MD at the clinic. How do I know? Our practice tracks patient ER visits, hospital re-admissions and amulatory care sensitive conditions that can be managed as an outpt versus ER/Hospital use.

It's my first year at this practice. I understand that I should expect to start low and will work my way up. But I'm wondering if I will ever make the 85% Medicare thinks my work is worth. The way I see it, if Medicare thinks I'm worth 85% of the full reimbursement then can I expect to someday see a salary that reflects 85% of what the MD's salary is?

I think not.

I'm thinking the word mid-level has put a ceiling on my career that will be challenging to rise above of. I was taught that the higher the risk, the more the reward. Well......., I'm seeing more patients than the other provider. More risk should equal more of a reward. I don't think this will ever happen.

I do enjoy my work though and I do find that my hard work and long hours are wonderfully justified when a patient returns to thank me for helping them through an illness or achieve control of a chronic condition. This is more of a reward than money can ever buy.

Just wanted to put my thoughts up to vent a little. Not looking for sympathy or a solution, just wanted to write my thoughts on a forum is all.

[traumaRUs, MSN, APRN]

I think you are right: you won't see 85% reward. Out of that 85%, you have to help with overhead of the office, staff salaries, EMR expenses if you have them, insurance (a biggie), credentialling, etc.

So, while your practice gets reimbursed 85% of what the doc would, you still would have to figure other expenses.

[TX RN]

I don't mean 85% of reimbursement. I'm referring to a salary that's approx 85% of what an MD with the practice expects to receive.

[ivanh3]

Is this your first year working with the practice or your first year working? Sounds like you are in a great learning environment, and like you said, its your first year. Keep track of all your stats and when it is time to negotiate your next salary then make your fact-based case.

Ivan

[TX RN]

First year with the practice.

Thanks Ivan. Yeah, it's a good place to learn and work at. I definitely plan on making a strong case come evaluation time. It's time to start working on my presentation.