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What is a reasonable new grad offer?

NP   (10,183 Views 26 Comments)
by NdoNP NdoNP (New Member) New Member

671 Visitors; 9 Posts

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futureeastcoastNP works as a RN.

10,269 Visitors; 533 Posts

Please ignore redlion's advice, he is either a physician or wannabe physician.

Redlion, of course they should be making money off of the NP, just as hospitals make money off of MDs. The difference here is the MARGIN. If the NP is pulling in 250K and being 80K, that's unfair. There is a difference in making money off of your employee and completely taking advantage of them. The OP has every right to fight for a fair offer, and it's quite clear from your attitude that you do not believe in fair compensation for NPs.

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BostonFNP works as a Primary Care NP.

18 Likes; 1 Follower; 3 Articles; 54,178 Visitors; 5,223 Posts

Businesses are motivated by profits. Physicians/administrators hire other providers (physicians, NPs, PAs) to make money. Some do it directly and others do it by secondary means but (almost) all of it is based on profits.

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545 Visitors; 7 Posts

Please ignore redlion's advice, he is either a physician or wannabe physician.

Redlion, of course they should be making money off of the NP, just as hospitals make money off of MDs. The difference here is the MARGIN. If the NP is pulling in 250K and being 80K, that's unfair. There is a difference in making money off of your employee and completely taking advantage of them. The OP has every right to fight for a fair offer, and it's quite clear from your attitude that you do not believe in fair compensation for NPs.

With all due respect what is "fair" and "unfair" is not determined by you or any other individual in a market economy. Barring corruption, a worker will be paid as little as possible whether he/she is an RN, NP or MD. As long as that payment is less than the profits that worker can make for the employer- he or she will be hired. An employer is not your "partner". He/she will not give you more because you "deserve" it or it's "fair". That line of thinking is what I would expect from an 8 year old.

But I'll give you an actual solution if you want NPs to make more: Decrease the supply (stop NP degree mills from proliferating) or increase the supply price (unionize- convince NPs to leave their cushy 80k-90k jobs for a labor strike).

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zmansc works as a RN.

10,886 Visitors; 867 Posts

With all due respect what is "fair" and "unfair" is not determined by you or any other individual in a market economy. Barring corruption, a worker will be paid as little as possible whether he/she is an RN, NP or MD. As long as that payment is less than the profits that worker can make for the employer- he or she will be hired. An employer is not your "partner". He/she will not give you more because you "deserve" it or it's "fair". That line of thinking is what I would expect from an 8 year old.

But I'll give you an actual solution if you want NPs to make more: Decrease the supply (stop NP degree mills from proliferating) or increase the supply price (unionize- convince NPs to leave their cushy 80k-90k jobs for a labor strike).

Or increase demand. Or increase income generation capabilities (100% reimbursement).

I agree with the basic lecture, that it's not about fair, it's about what the market will drive. This is why I think independent practice and removing restrictions on practice are so important for us to focus on.

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671 Visitors; 9 Posts

He countered with $25/patient with up to 4 weeks time off. That way I have flexibity & get paid based on productivity. I don't want to have to manage %'s so a set rate works great for me. All I have to do is track my number of patients. Everything else the same.

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zahryia works as a Staff Nurse.

9,051 Visitors; 537 Posts

Whoa! That's a pretty good offer. Am I missing something here?

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BostonFNP works as a Primary Care NP.

18 Likes; 1 Follower; 3 Articles; 54,178 Visitors; 5,223 Posts

He countered with $25/patient with up to 4 weeks time off. That way I have flexibity & get paid based on productivity. I don't want to have to manage %'s so a set rate works great for me. All I have to do is track my number of patients. Everything else the same.

Depends on what type of patients you will be seeing. Do you have to build your own panel?

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671 Visitors; 9 Posts

No walk into a practice with a long wait list to get in

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futureeastcoastNP works as a RN.

10,269 Visitors; 533 Posts

No walk into a practice with a long wait list to get in

Sounds great then. I'm glad you countered, especially with the vacation time. You will be happy to have that! Good luck at your new position!

To all NPs: let this be a lesson. Do NOT take the first offer. Almost all employers first offer the lowest they will go assuming you will counter. If you accept the first offer you are really hurting yourself. It never hurts to counter. Worse thing they can do is refuse.

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545 Visitors; 7 Posts

Or increase demand. Or increase income generation capabilities (100% reimbursement).

I agree with the basic lecture, that it's not about fair, it's about what the market will drive. This is why I think independent practice and removing restrictions on practice are so important for us to focus on.

I highly doubt reimbursement equal to MDs will ever happen. Let's not forget that the NP is supposed to be a VALUE proposition. If it's going to be equal reimbursement to an MD's services why not just lower the admission bar for med school and create more MDs?

No matter where healthcare worker pay goes- NPs will always be paid lower than MDs. Most likely- both will very slowly stagnate to European levels over the course of maybe 50 years (where most MD's make 80k and nurses much less).

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BostonFNP works as a Primary Care NP.

18 Likes; 1 Follower; 3 Articles; 54,178 Visitors; 5,223 Posts

I highly doubt reimbursement equal to MDs will ever happen. Let's not forget that the NP is supposed to be a VALUE proposition. If it's going to be equal reimbursement to an MD's services why not just lower the admission bar for med school and create more MDs?

No matter where healthcare worker pay goes- NPs will always be paid lower than MDs. Most likely- both will very slowly stagnate to European levels over the course of maybe 50 years (where most MD's make 80k and nurses much less).

I agree with you about NPs providing cost effective quality care. The problem that most providers working in primary care understand is that reimbursement has gotten so low that an NP taking 20% less is almost unsustainable.

Because of the sheer cost and amount of time it takes to educate and train them in the current system.

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275 Visitors; 1 Post

My starting pay is about $10,000 less, $5000 sign on bonus, relocation, 4 days per week, no call, 32 days vacation/holiday per year, $2500 CME. I felt like the starting pay could have been a little higher, but everything else is great and I love the practice.

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