Why is our salary so low?

Published

Something I grapple to understand is how come our average salaries are in the $99k range. Is it because most NP's are new to the career and that skews it do the lower end?

If we are reimbursed 80% of what physicians get, why are we paid 1/4 of what physicians make? In independent states where you open up your own practice, how much do you make?

Specializes in Psych.
although most of us are not expecting doctor pay.

i don't think we disagree at all...

see what I just did there :)

most of my original post was spent discussing my salary, why it could have been more, but that there were other variables for me involved.

but I do agree with you in fact. I too have worked some some pretty rediculous doctors and I was definitely giving better care for the patients and being compensated less. I've also seen them get their comeuppance: legal troubles, lawsuits, etc. things always catch up with the worst of them in the end, and yet they worry we're going to do something to get them sued! Lol.

I've also worked with excellent doctors. My first job, I worked with a wonderful child psychiatrist who reviewed every single case I saw that week with me. He taught me how to prescribe...something, sadly, I did not learn in clinical, because no one would or could let me do it.

Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.

I've also worked with excellent doctors. My first job, I worked with a wonderful child psychiatrist who reviewed every single case I saw that week with me. He taught me how to prescribe...something, sadly, I did not learn in clinical, because no one would or could let me do it.

A classic example of how woefully lacking our NP education can be and imagine if you hadn't had this wonderful psychiatrist as a resource to guide you in the beginning. I shudder to think what the future will bring as more and more become NPs without ever having worked as a RN.

Up Vote Up Vote ×
Specializes in Adult Gerontology Primary Care NP.
This doesn't explain the proliferation of direct entry MSNs - and it also doesn't allow that a huge chunk of an MD's knowledge isn't gained in school either. School teaches them the background and the mechanics. While an intern is still a student, they're also doctors, and are paid as doctors (yes, I know it's a pittance, but who's monitoring that floor at 0200? In a teaching hospital, you're calling the intern).

yes, and in many major hospitals, you are calling an NP/PA at 02:00.

also, have you ever worked with residents or fellows or attendings? Maybe it is because I am at an academic center, I see what happens behind the facade of the "know it all" physician. They are constantly learning and sharing knowledge. The good NPs do the same. There is on the job learning for everyone on the team, because medicine is constantly changing.

I question the motives of those who need to defend the MDs at the cost of throwing nursing under the bus. What is with this forum?

Up Vote Up Vote ×

Just a few comments. I read others posting physician salaries, but they didn't post how they got those figures. The average physician is not making as much money as you would like to think. If they work for a hospital (as an employee) they may actually do better than in private practice, but there is a lot of politics involved. The nurse practitioner salaries discussed are also very high. Yes there are some people making that (especially psych) but most aren't. If you want to make over $100,000 with 36 hours/per week of work, just be a nurse. As for B&M versus online: Many B&M universities now offer the NP program online. No one will know whether or not you sat in a classroom. Also, there is a huge difference between a very experienced nurse going back to school and choosing online education and a nurse moving directly from the BSN program to online or even B&M NP education.

I really fault the NP programs for insisting on a different type of program than every other professional goes through, chiefly lack of hospital rotations, and no help in securing clinical sites. All NPs should have hospital rotations, as well as specialty rotations regardless of focus.

Just a thought.

Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.
Just a few comments. I read others posting physician salaries, but they didn't post how they got those figures. The average physician is not making as much money as you would like to think. If they work for a hospital (as an employee) they may actually do better than in private practice, but there is a lot of politics involved. The nurse practitioner salaries discussed are also very high. Yes there are some people making that (especially psych) but most aren't. If you want to make over $100,000 with 36 hours/per week of work, just be a nurse. As for B&M versus online: Many B&M universities now offer the NP program online. No one will know whether or not you sat in a classroom. Also, there is a huge difference between a very experienced nurse going back to school and choosing online education and a nurse moving directly from the BSN program to online or even B&M NP education.

I really fault the NP programs for insisting on a different type of program than every other professional goes through, chiefly lack of hospital rotations, and no help in securing clinical sites. All NPs should have hospital rotations, as well as specialty rotations regardless of focus.

Just a thought.

Good points and I can only speak for my assertions and salary. Yes I am at the high end and as I have added previously I have a decent business sense, solid experience, a good reputation and multiple physician contacts who have made things happen for me with regard to opportunities.

The way I know what the psychiatrists I work with make is because I'm friends with a couple of them as well as executive director of a large center who have discussed salaries with me. I know about additional physician reimbursement based on my weekend rate negotiations when the discussion turned to my request vs psychiatrist staff vs locums rates. A girlfriend who's husband is a rural PCP makes $175,000 and a friend of mine who is an ED doc makes around $250,000. As you pointed out this is only worth what the reader paid for it, nothing, and on an internet message board anyone could write anything with no ability to back it up however I'd urge skeptics not to allow this to be a flimsy excuse to continue slogging along for piss poor wages doing RN tasks and instead investigate, network and push for the best compensation package they can obtain.

Up Vote Up Vote ×
yes, and in many major hospitals, you are calling an NP/PA at 02:00.

also, have you ever worked with residents or fellows or attendings? Maybe it is because I am at an academic center, I see what happens behind the facade of the "know it all" physician. They are constantly learning and sharing knowledge. The good NPs do the same. There is on the job learning for everyone on the team, because medicine is constantly changing.

I question the motives of those who need to defend the MDs at the cost of throwing nursing under the bus. What is with this forum?

You should talk to a US med student so you can learn what it takes to even get into med school... Do you know any nurses who have been rejected from NP school. Your education is a joke!

Up Vote Up Vote ×

Some of the post on this thread reminded me of a conversation I had a long time ago when I worked as RN in an LTACH. It was the middle of the night I was working with an LPN and she had the argument that she should be paid the same amount as an RN. Several of us were in the discussion and she got got hot arguing her point. To her, she did the same work that the RN did and she felt she should make the same amount.

My arguments than and still now was that there were some differences in job function between RN and LPN and the RN has more education along with an overall greater investment in their education. The pay increments were acknowledgement of that investment along with incentive for each of us to work towards the next rung on the ladder. LPN to ADN to BSN to MSN and so on.

Later in my career I would hear the same argument for the ADN making the same as the BSN and still later the BSN and MSN and not the MSN trained NP vs the DNP. Someone is always gonna look at the situation how it pertains to them without stepping back and seeing the big picture.

In my state and others NPs cannot practice independently and there are many things we cannot do that physicians can. Plus they do have do have more invested in their education and overall clinical hours. Should we work for peanuts no and I do agree somewhere in the 60-80% range should be expected based on experience and practice capabilities but we are not physicians and that is okay.

Up Vote Up Vote ×
You should talk to a US med student so you can learn what it takes to even get into med school... Do you know any nurses who have been rejected from NP school. Your education is a joke!

I'm not sure I understand this comment. There is a place for everyone at the table. I know physicians who will consult with NPs about a subject because that NP is an expert in the area. I've also heard physicians praising an NP in another practice, because of their knowledge and the way they run a specialty program. Also, be very careful when talking about NPs. I know some who were at the height of their career when they decided to move to the US and did not want to go through residency again. So they chose instead to become PAs or NPs. They can teach their supervising physician, but when I ask them how they're doing, all I hear is "great!" I would hate for someone to make a rude comment to one of these very educated NPs.

Many people talk about what it takes to get into med school vs NP program. I'm sure you know nurses who left nursing and went to med school. Brains are everywhere...it's about what you want to do and the time and effort you're willing to put into it. Just saying.......

Up Vote Up Vote ×
Some of the post on this thread reminded me of a conversation I had a long time ago when I worked as RN in an LTACH. It was the middle of the night I was working with an LPN and she had the argument that she should be paid the same amount as an RN. Several of us were in the discussion and she got got hot arguing her point. To her, she did the same work that the RN did and she felt she should make the same amount.

My arguments than and still now was that there were some differences in job function between RN and LPN and the RN has more education along with an overall greater investment in their education. The pay increments were acknowledgement of that investment along with incentive for each of us to work towards the next rung on the ladder. LPN to ADN to BSN to MSN and so on.

Later in my career I would hear the same argument for the ADN making the same as the BSN and still later the BSN and MSN and not the MSN trained NP vs the DNP. Someone is always gonna look at the situation how it pertains to them without stepping back and seeing the big picture.

In my state and others NPs cannot practice independently and there are many things we cannot do that physicians can. Plus they do have do have more invested in their education and overall clinical hours. Should we work for peanuts no and I do agree somewhere in the 60-80% range should be expected based on experience and practice capabilities but we are not physicians and that is okay.

Very well said. There must be some kink of reward for investment in time and sacrifices made. I absolutely admire and respect all those who go through that rigor.

Up Vote Up Vote ×
I'm not sure I understand this comment. There is a place for everyone at the table. I know physicians who will consult with NPs about a subject because that NP is an expert in the area. I've also heard physicians praising an NP in another practice, because of their knowledge and the way they run a specialty program. Also, be very careful when talking about NPs. I know some who were at the height of their career when they decided to move to the US and did not want to go through residency again. So they chose instead to become PAs or NPs. They can teach their supervising physician, but when I ask them how they're doing, all I hear is "great!" I would hate for someone to make a rude comment to one of these very educated NPs.

Many people talk about what it takes to get into med school vs NP program. I'm sure you know nurses who left nursing and went to med school. Brains are everywhere...it's about what you want to do and the time and effort you're willing to put into it. Just saying.......

I am all for foreign docs to do NP here... I welcome that so these diploma mills can disappear when people who graduate from them can't get no jobs... The whole NP stuff has become a scam for the most part in my opinion... I am glad some institutions and physicians are starting to see that.

Up Vote Up Vote ×

@JellyDonut... NP are expert in what? Because you work in a specialty, that does not mean you are an expert in that particular specialty. You guys play with words like they don't mean anything... Physicians like my cousin have been f... before due to some reckless specialty physicians who want to make cheap money. They send NP to take care of consults when these people have no idea about what's going on. Unfortunately, patients needlessly die or deteriorate when these unscrupulous docs do stuff like that... My cousin has learned his lesson, so now he specifically put in his consult orders that NP/PA are not to see his patients for consult and there were a lot docs where i used to work at that do similar stuff...

Up Vote Up Vote ×

What anders was saying is it's easier to slip through the cracks as somebody who has no brain power thru np school than med school. Which is an absolute fact.

But there are good providers of all sort if they work hard. Only problem is people think that just bc they are being challenged means they are gonna be competent. Very few NP schools are challenging enough unfortunately.

Up Vote Up Vote ×
+ Join the Discussion