What NP specialty offers the most flexibility?

Nursing Students NP Students

Published

I am applying to a nurse practitioner program and would like some advice on what specialties are like. I was a medical school student that left medical school because I realized that the demands of a doctor and quality of life was not something I wanted to pursue further so I left in my first semester of medical school. However, I love patients and I love caring for people so I would like to work as a nurse practitioner. Which specialties offer the most flexibility? I feel like as a Acute Care Nurse Practitioner (ACNP) you can work in different settings such as inpatient care and outpatient care. I want to be able to do research and be able to work in the clinic.

Specializes in PMHNP Student.

Although working for myself sounds attractive, own boss etc...I prefer just to be employed. Don't want to deal with the headache of recruiting patients, advertising to get enough patients etc. Then paying for the overhead of an office and staff. That just seems like too much esp. if starting out. Although I'll be the first to admit I'm a scaredy cat! LOL 

Specializes in Psych/Mental Health.

I don't think I would want to go solo and have to deal with billing and scheduling. It shouldn't be too hard to find a private group that'll give you a lot of autonomy. Although it might be a 60/40 to 70/30 split, you won't have to deal with all the other matters (60/40 is still pretty decent if you're taking private insurance or cash). But these jobs usually will require that you have 1-2 years of NP experience and that you don't need supervision.

Specializes in ICU, trauma, neuro.

Here are some possibly relevant thoughts related to this subject:

a. Many places you will end up doing much of your own scheduling (certainly many tele positions).

b. Finding customers may be a challenge at first. Although, I get notices of about 20 calls per week from my Psychology Today add. I will be honest I don't call any of these back (my number at my group is listed if they want to call intake and ask for an appointment). I do email every customer who emails me back.  My point is that even with Psychology Today being my only advertising I could probably obtain a reasonably full schedule within a year.

c. If you are "cash only" it reduces the headache of billing. Even at the group that I'm at now I don't charge for missed appointments nor do I ever pursue collections (I suppose at some point I might stop seeing a patient if they don't pay or miss too much, but that hasn't happened yet). My attitude is that "over all" I make good money so I don't worry about what falls through the cracks.

d.  Even as a new graduate I had seven or eight offers in the 60-80% range at various locations around the country.  Granted only one of those had a fully remote option (probably about 60% when you consider fees).  

e. My wife worked with a PMHNP who now works in Alabama (not known for pay or good scope of practice) who's supervising MD pays her 80%.  They bill at around $300.00 per hour ($300 for a 60 minute intake and $150.00 for a 30 minute followup) Thus, she earns around $240.00 per hour (minus no shows) and she is full every day.  If you can earn about $200.00 in Alabama you can probably do it in most places with the proper set up.

3 Votes
Specializes in PMHNP Student.

wow that's great! Puts a whole new perspective on private practice. I will definitely keep that option open, as I know when I start out I can't be too picky. My one caveat is that I need something somewhere where it doesn't snow. Living in the snow belt I'm just tired of being frozen/cold/chilly 8 months of the year. I wouldn't have imagined in Alabama!!

Specializes in PMHNP Student.

Is she salaried or private practice?

Specializes in Public Health Science.
On 9/18/2020 at 1:44 PM, Angie Hunter said:

Although working for myself sounds attractive, own boss etc...I prefer just to be employed. Don't want to deal with the headache of recruiting patients, advertising to get enough patients etc. Then paying for the overhead of an office and staff. That just seems like too much esp. if starting out. Although I'll be the first to admit I'm a scaredy cat! LOL 

Its not a bad thing to be employed than own your own business. I own my own business (not in healthcare) and I am not sure I would own another business again. But it is good to have the option. Thanks for the feedback. 

Specializes in Psych/Mental Health.
9 hours ago, Future MSN said:

Its not a bad thing to be employed than own your own business. I own my own business (not in healthcare) and I am not sure I would own another business again. But it is good to have the option. Thanks for the feedback. 

This is possible mostly in psych NP. I don't believe owning your own practice is possible with ACNP, certainly not remote telemed (at least for now). It's a good option if there's strong interest in this population.

1 Votes
Specializes in ICU, trauma, neuro.

Well, when I worked ICU there was an NP (not sure if he was an ACNP) who pretty much handled call for the cardiologists and many other MD's in the hospital on night shift. Which is to say I he is the one that called me back when I needed orders for someone in ICU who wasn't being covered by the intensivist team (but who was covered by cardiology).  However, he also came in to the hospital several mornings per week. I believe that there could be a need for someone who covered weekends and nights for MD's especially in rural locations. However, avoiding having to come in person might be tricky.

On 9/18/2020 at 5:45 PM, Angie Hunter said:

Is she salaried or private practice?

She earns 80% 1099. No benefits.  Since it is a collaborative practice state she also isn't "private practice".  Let me say even in Florida I've had at least one Psychiatrist who offered to be my collaborative MD for 7% of gross collections.   

Specializes in CARN.
On 9/6/2020 at 1:40 AM, myoglobin said:

I believe that PMHNP is decent. Granted I end up working every day of the week, mostly because I'm very ADHD and inefficient.  However, I actually only see clients three days per week and am on track to earn at least 200k (no benefits however) despite being a first year graduate (and I work from home).  As an ICU RN with ten years experience I never received a raise beyond the $38.00 per hour (no benefits) that I earned for my three twelve hour night shifts per week.  Granted, I could have worked an additional one, two or even three days of overtime as many of my coworkers did, but every shift was such a "battle for survival" that there was no way I could have done that certainly not on a regular basis.

Curious what state you are in?  and what type of facility? That is good money I was told it is $110,000 a year.

Specializes in ICU, trauma, neuro.

Currently, I live in Florida and work as a PMHNP in Washington state via telehealth. When I worked as an ICU RN it was in Florida which is where I earned the $38.00 per hour.  

Specializes in CARN.
22 minutes ago, myoglobin said:

Currently, I live in Florida and work as a PMHNP in Washington state via telehealth. When I worked as an ICU RN it was in Florida which is where I earned the $38.00 per hour.  

I too live in Florida, Orlando /Daytona area. that seems to be the rate alright. may I ask what type of telehealth company you work for? I'm starting my PMHP/Doctorate program in dec. so I'm trying to decide what way to go.

Specializes in ICU, trauma, neuro.

The company that I work for is in Washington state and they do both telehealth and onsite, outpatient. I pay 30% of gross revenues and an additional $600.00 per month in fees. They do my scheduling, marketing, followup calls to clients, insurance billing and credentialing. I also have access to an office up to three days per weeks (trying to expand to four days) if and when I should require it.  Thus, I can be both a telehealth and in person provider.

+ Add a Comment