Why is our salary so low?

Carabella · Oct 1, 2016

So some NP applies for a position with less than 2 years nursing experience and a degree from Walden and she should make almost as much as a physician. That is a hard pill to swallow!

If she has passed the NP exam, what difference does it make if she graduated from Walden (an accredited school)? If she is excelling in her work and the practice gets to bill for her services, she (or he) is entitled to excellent compensation. Nobody who graduates with a hard earned MBA or law degree "takes a knee" in terms of compensation and humbly says, "Oh, how could I ever make a great salary, I am new, and I didn't go to an Ivy League school..." They go out there and get everything they can earn!!! We nurses work dang hard for both our primary degrees and advanced ones! We literally save lives and deal with MAJOR responsibility! We need to start advocating for fabulous salaries. Because we can do good, serve humanity, and still earn!

rideahorse1 · Oct 1, 2016

If you want to make physician salary, I suggest you go to medical school. Many NP students these days don't want to work as a nurse, don't want to take the GRE, want an online school because they don't want to drive, want "mommy hours" and still believe that they should make an MD salary.

Can you imagine taking your child to an MD who didn't want to take the MCAT, went to an online school and never spent a day in a hospital? Half the psych NP's I know never have spent a day on an inpatient psychiatric unit. SCARY. MD's spent years and years in the trenches. This profession does it to ourselves every time. I am very wary of NP's these days, the quality has gone down.

When there continues to be a massive influx of low experience, online NP's the salaries will take a further hit. It happened in nursing, and it will happen in the NP market.

Carabella · Oct 1, 2016

Again, with all do respect, we do it to ourselves... Firstly, even if you have earned a doctorate in circus arts, you are a "DR." It is an academic title - not a physician copyrighted title. Physicians weren't always called "Dr", either. It was only when they introduced the MD education from Europe to improve their standard of care. Prior to this, they actually practiced quackery (look at physician notes from the 17-18 hundreds about the practice of bloodletting). Even the lab coat was an attempt to be taken more seriously. Look at old pics - they wore all black.
lastly, the confident physicians actually admire DNPs for what they bring to the table. And the confident DNPs will introduce themselves either by their first name or "Dr. XYP and I'm an NP"...
In regards to salary negotiation, you can also offer to work at the agreed salary with the expectation that you get a increase after a few months, because you will likely not be as productive in the orientation/beginning phase. Then, just start knocking them out. ;-) if they don't agree, find another job, which is actually another way to increase your salary. You will be more competitive. Good luck!!

Totally agree... If I were to become a nurse practitioner/DNP and worked in the ER, I would approach the patient as follows: "Hello, Mr. Jones, I am Dr. Cara Bella. I am a Nurse Practitioner and I will be taking care of you today." Depending on the formality of the situation I also might say, "Please call me Cara."

elkpark · Oct 1, 2016

Again, with all do respect, we do it to ourselves... Firstly, even if you have earned a doctorate in circus arts, you are a "DR." It is an academic title - not a physician copyrighted title. Physicians weren't always called "Dr", either. It was only when they introduced the MD education from Europe to improve their standard of care. Prior to this, they actually practiced quackery (look at physician notes from the 17-18 hundreds about the practice of bloodletting). Even the lab coat was an attempt to be taken more seriously. Look at old pics - they wore all black.
lastly, the confident physicians actually admire DNPs for what they bring to the table. And the confident DNPs will introduce themselves either by their first name or "Dr. XYP and I'm an NP"...
In regards to salary negotiation, you can also offer to work at the agreed salary with the expectation that you get a increase after a few months, because you will likely not be as productive in the orientation/beginning phase. Then, just start knocking them out. ;-) if they don't agree, find another job, which is actually another way to increase your salary. You will be more competitive. Good luck!!

Please go back and reread the post from AAC.271 to which I was responding, and what I said. AAC.271 referred to DNP-prepared NPs referring to themselves as "Dr. So and so and saying that they are the doctor." I responded that I support doctorally-prepared NPs (or any other health professionals) using the title "Dr." -- my issue was with the "saying that they are the doctor" part. I'm probably as well-informed about the history of medicine as you are and have been arguing that physicians don't own the title "doctor" for years, but the reality is that, right or wrong, a lot of physicians and employers are going to have big-time problems with nurse practitioners introducing themselves as "I'm Dr. XYZ and I'm the doctor" rather than "I'm Dr. XYZ and I'm the nurse practitioner" (as you, yourself, suggested would be appropriate).

If you want to take on the medical community and attempt to convince them that nurse practitioners with doctorates should be able to introduce themselves to clients as "the doctor" rather than "the nurse practitioner," by all means, go for it.

Jules A, MSN · Oct 1, 2016

If you want to make physician salary, I suggest you go to medical school. Many NP students these days don't want to work as a nurse, don't want to take the GRE, want an online school because they don't want to drive, want "mommy hours" and still believe that they should make an MD salary.
Can you imagine taking your child to an MD who didn't want to take the MCAT, went to an online school and never spent a day in a hospital? Half the psych NP's I know never have spent a day on an inpatient psychiatric unit. SCARY. MD's spent years and years in the trenches. This profession does it to ourselves every time. I am very wary of NP's these days, the quality has gone down.
When there continues to be a massive influx of low experience, online NP's the salaries will take a further hit. It happened in nursing, and it will happen in the NP market.

Omg I think I found my soulmate!

Damselle · Oct 2, 2016

No, potential employers don't look at what kind of school we graduated from: Ivy League, State University, Hands on, online..... They do look at years of experience, type of experience, how you present yourself, and how you fit into the culture of the clinic, or facility. Then there's location and specialty.

In in my state, near the bigger cities, $100,000 would be entry level, but in the rural areas, that might be competitive. I live in a rural area were I drive 45-60 minutes to get to any job. As a psych NP, I'm in high demand. I could have taken the job at the clinic where I was doing locums. They offered me $15 more per hour more than where I'm working now, but the staff where incompetent and not helpful, the clinicians where ineffective, the environment was dirty, and the clients where all on an assortment of medications I didn't want to continue. Oh, and, the deal breaker, they wanted me to work Saturdays.

so, I work for less money, Mom- Thurs, 36 hours, I have my own Medical Assistant who does everything for me, the clianians I work with are mostly great, and the environment is nice. I still make over $100,000....

Now, in my area, we have a plethora of family and adult Np's, so they have a harder time negotiating a good salary. It's also about supply and demand.

I don't expect to make what a doctor makes. I didn't go to school for eight years and do four plus or even more years of residency. I don't have hundreds of thousands of dollars in student loans.

common guys. Let's get real here.

PG2018 · Oct 2, 2016

While I am all for NP's with a DNP introducing themselves to patient's as Dr. So and so and saying that they are the doctor, I'm not sure if it is a good idea to say to them that you went to medical school as well.

Who the heck said that?

PG2018 · Oct 2, 2016

That is hardly the case with any new NP especially one with very little clinical experience. Even the best prepared newly licensed NP will face a learning curve to get up to speed. I think new graduated should expect a lower pay scale and once they have a year or two under their belt it is time to renegotiate or find an employer that will value the experience you have gained.

If you know what you're going to bill you need to take in ay least 80% regardless of what your academic initials are.

PG2018 · Oct 2, 2016

Again, with all do respect, we do it to ourselves... Firstly, even if you have earned a doctorate in circus arts, you are a "DR." It is an academic title - not a physician copyrighted title. Physicians weren't always called "Dr", either. It was only when they introduced the MD education from Europe to improve their standard of care. Prior to this, they actually practiced quackery (look at physician notes from the 17-18 hundreds about the practice of bloodletting). Even the lab coat was an attempt to be taken more seriously. Look at old pics - they wore all black.
lastly, the confident physicians actually admire DNPs for what they bring to the table. And the confident DNPs will introduce themselves either by their first name or "Dr. XYP and I'm an NP"...
In regards to salary negotiation, you can also offer to work at the agreed salary with the expectation that you get a increase after a few months, because you will likely not be as productive in the orientation/beginning phase. Then, just start knocking them out. ;-) if they don't agree, find another job, which is actually another way to increase your salary. You will be more competitive. Good luck!!

I'm also ok with absolutely anyone with a doctorate calling themselves doctor. My PCP, a DO, walks in on new patients, sticks his hand out and says "Joe Blow, what can I do for you" as his introduction.

But obviously his real name isn't joe blow

PG2018 · Oct 2, 2016

If you want to make physician salary, I suggest you go to medical school. Many NP students these days don't want to work as a nurse, don't want to take the GRE, want an online school because they don't want to drive, want "mommy hours" and still believe that they should make an MD salary.
Can you imagine taking your child to an MD who didn't want to take the MCAT, went to an online school and never spent a day in a hospital? Half the psych NP's I know never have spent a day on an inpatient psychiatric unit. SCARY. MD's spent years and years in the trenches. This profession does it to ourselves every time. I am very wary of NP's these days, the quality has gone down.
When there continues to be a massive influx of low experience, online NP's the salaries will take a further hit. It happened in nursing, and it will happen in the NP market.

I might point out that most malpractice claims are made on FMGs. I note this because although physicians pass a standard set of tests, they may not be competent. Likewise, my certifying exam assessed little to nothing of a clinical nature, yet I went into practice and my own wherewithal has led me to study and do well. I'm a great tester and like the FMGs could probably scrape by on a USMLE or COMLEX.

I think online schools are ridiculous. I think hunting down your own preceptor is ridiculous. I think all NP schools has a ridiculous curriculum. However, I the indoctrination of nursing is what makes so many NPs retarded clinicians. They want to help, care, or save at the expense of being a serious book cracking diagnostician. Many nurses want pay and prestige with little preparation. After all, it's nurses who so commonly say "you don't need to know [insert science] to be a good nurse" and so goes a nurse evolution to a NP. A nurse wanting the glories of doctor while still holding the mindset of nurse.

PG2018 · Oct 2, 2016

No, potential employers don't look at what kind of school we graduated from: Ivy League, State University, Hands on, online..... They do look at years of experience, type of experience, how you present yourself, and how you fit into the culture of the clinic, or facility. Then there's location and specialty.
In in my state, near the bigger cities, $100,000 would be entry level, but in the rural areas, that might be competitive. I live in a rural area were I drive 45-60 minutes to get to any job. As a psych NP, I'm in high demand. I could have taken the job at the clinic where I was doing locums. They offered me $15 more per hour more than where I'm working now, but the staff where incompetent and not helpful, the clinicians where ineffective, the environment was dirty, and the clients where all on an assortment of medications I didn't want to continue. Oh, and, the deal breaker, they wanted me to work Saturdays.
so, I work for less money, Mom- Thurs, 36 hours, I have my own Medical Assistant who does everything for me, the clianians I work with are mostly great, and the environment is nice. I still make over $100,000....
Now, in my area, we have a plethora of family and adult Np's, so they have a harder time negotiating a good salary. It's also about supply and demand.
I don't expect to make what a doctor makes. I didn't go to school for eight years and do four plus or even more years of residency. I don't have hundreds of thousands of dollars in student loans.
common guys. Let's get real here.

But here's the deal you're being reimbursed for work done. Whatever the % a physician gets, unless an owner, should be the same % a NP or PA gets from revenue. Whether Medicare pays 100% or 85% is irrelevant.

So for example, I generally retain 93 +/- 2% of my revenues. The practice takes the rest to pay other overhead.

kellyshel · Oct 2, 2016

I agree completely!! I am 2 1/2 years into my online FNP program and will graduate in May '17! I feel that I have been challenged and pushed the entire time, my program has not been "fluff" or easy and am proud of the work I have had to put into my studies. I absolutely believe that I will be as good of an NP as a b & m graduate!!