NR 510 Week 3 Discussion Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
NR 510 Week 3 Discussion Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
NR 510 Week 3 Discussion Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
According to salary.com the average US NP makes approximately $116,000 per year. The same site states that the average salary in my area is between $108,000 and $126,000 per year. Danielsen, Potenza, and Onieal (2016) suggest that you should not think that the salary of the position you are pursuing has a predetermined rate. Considering a previous rate of approximately 20 patients a day and a projected rate of 24 patients a day, a salary of $117,000 would be appropriate. Using Buppert’s equation, seeing 20 patients a day would produce an approximate salary of $106,000 and seeing 24 patients would produce an approximate salary of $128,000. If you take both salaries and average them it is approximately $117,000, a fair rate in the current market of NPs. This also leaves room for negotiation for the next contract when goals are met. Considering this position is a contract position, I would not hesitate to ask for a bonus based on performance, collection rates, and revenues. Independent contractors typically provide for their own medical insurance, malpractice insurance, and continuing education costs, this is a substantial savings to the practice. In New Jersey the cost of a family health care plan can cost an employer more than $20,00 yearly, while malpractice insurance costs approximately $2000 a year for a family practitioner (NSO.com).
Resources:
Danielsen, R., Potenza, A. & Onieal, M. (2016). Negotiating the professional contract. Clinician Reviews, 28-33.
Decapua, M. (2016). How much revenue does a primary care nurse practitioner generate? Retrieved from https://www.bartonassociates.com/blog/how-much-revenue-does-a-primary-care-nurse-practitioner-generate/
Nurses Services Organization. (2018). Quick Quote for Individual Professional Liability Insurance. Retrieved from https://forms.nso.com/mustela/site?productName=HCI#/QuickQuoteDetails.
Salary.com. Nurse practitioner salaries in Toms River, NJ. Retrieved from https://www1.salary.com/NJ/Toms-River/Nurse-Practitioner-salary.html
I had an experience to try to negotiate my salary as an RN when laterally moving from a per diem position to a full-time position at my current job. I was per diem and circumstances at the hospital meant that I may not be able to work as much as I would like. I took a position with a differential then before my transfer a full-time position opened on the unit I was working on. I wanted to stay on the unit, but I did not want to lose the differential of the other position since I was taking a cut in pay from the per diem position. I had a meeting with my manager and told her that I needed a little higher of a salary to take the position on my unit. Unfortunately, one of the hospitals in our system is union and there is a set protocol for pay. However, since my manager really wanted me to stay on the unit I was given the salary of an RN with 5 years-experience even though I was several months from that anniversary. I would have stayed even if I didn’t get more money. That was the job that I really wanted. Happiness in your position is sometimes more important than salary. Gillet, Fouquereau, Coillot, Cougot, Moret, Dupont, Bonnetain, and Colombat (2018) in their study of job satisfaction and quality of care found “the present results revealed that job satisfaction related positively to quality of care and negatively to turnover intentions” (p. 1215).
Resource:
Gillet, N., Fouquereau, E., Coillot, H., Cougot, B., Moret, L., Dupont, S., Bonnetain, F., & Colombat, P. (2018). The effects of work factors on nurses’ job satisfaction, quality of care and turnover intentions in oncology. Journal of Advanced Nursing, 74, 1208-1219.
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I would propose a salary starting with the base of the 20 patients per day I would see and calculate from there similar to Buppert (2011), including costs, consults, sick time, vacation, and continuing education which would be around $105,000. This base rate varies by state and specialty, taking for instance the 2012 survey in Arizona depending on the nurse practitioners specialty the salaries range from 24,000 to 103,000 dollars (Widemark,2012). According to this scale the range would not be correct therefore it is important to know the state salary and living expenses in which you are in. Another driver of the wages one will make as an nurse practitioner is the demand for nurse practitioners in that area, as the need for mid level providers increases the wages will increase until the void is fulfilled. According to the bureau of labor the number of nurse practitioners in some states is minimal yet they are being paid some of the highest in the country to keep up with the competitive salaries of those states with more demand for nurse practitioners (Bls.org,2017)
Bureau of Labor Statistics,2017, Bls.org
Widemark,2012. Nurse practitioner salary survey. Nurse practitioner world news
Since I am a family nurse practitioner nursing student I could only make a guesstimate on what should be the proper salary for a practicing nurse practitioner. Actually the only research I have looked into when it comes to nurse practitioner salaries is the common median salary for a nurse practitioner in the state of Texas. From the various websites and from talking to actual nurse practitioners the median in Texas seems to be over $100,000. I would have to learn more and actually become a nurse practitioner to figure out the true salary that I believe I deserve and would work towards obtaining in the future. Apparently according to other nurse practitioners at the organization that I work at, the amount of patients that you see will contribute to salary. I would strive to see a good amount of patients ranging from 20 to 24 patients based on the salary breakdown on the question above. I would propose for $110,000 to $120,000 salary based median. I believe that fits with the common median of what a nurse practitioner who makes. One also has to understand where the nurse practitioner is working because based on where the nurse practitioner is working it will affect and contribute to how much the NP will make in a year. For example a nurse can work at a private practice office, a clinic, or even go a step further and work in the hospital setting as an advanced nurse practitioner. It is important that a nurse practitioner keeps up with the current salaries because it is important that he or she gets paid the correct amount that he or she deserves. Nurse practitioners do have more advocacy and independence then a bedside nurse however there comes more responsibility. I do believe that as a nurse practitioner games more responsibility I believe that the salary needs to be revised and examined. Patients are becoming more complex and critical and there is a shortage of actual practicing physicians . This is One of the reasons that nurse practitioners are gaining more responsibility and I believe as nurse practitioners gain more task and responsibilities that the salary should be increased. (Levine, 2015)
Referances: Levine, J. (2015). Nurse practitioner practice characteristics, salary, and benefits survey, 2003. Clinical Excellence For Nurse Practitioners, 9(1), 49-58.
NPs salaries is an important discussion because it directly ties in with our work ethic. The connection between pay and the NPs work attitude is a subject that is typically swept under the rug. When pay is brought up, physicians argue they charge less for NP services. Yet, physicians want to collect the most money they can from NP fees. While nurse practitioners continue to draw lower salaries because doctors charge lower fees for NP services, NPs are doing more and more work. Our duties and scope of practice has expanded due to legislation that has been passed. True, NPs want full practice and prescriptive authority, but we also want an increase in pay. As the medical field relies more on NPs to fill the primary care physician void reimbursement and salary issues must be addressed to avoid a backlash from NPs (Ulrich et al., 2014). Salary transparency is a positive factor; however, salary transparency combined with pay fairness and pay raises eliminates employee turnovers and employee dissatisfaction.
Research conducted by the Society for Human Resource Management shows a fair and transparent pay process boosts employee engagement more than providing additional pay (Miller, 2017). I am a proponent of both: fair and transparent pay and additional pay. Just having an open dialogue about pay is not enough for me. I appreciate the accolades about my contributions to the practice and patients’ health welfare, but ultimately, I want to be compensated for my work.
References:
Miller, S. (2017). Pay fairness perception beats higher pay for improving employee engagement. Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/compensation/pages/pay-fairness-beats-higher-pay-for-engagement.aspx
Ulrich, C. M., Zhou, Q. (Pearl), Hanlon, A., Danis, M., & Grady, C. (2014). The impact of ethics and work-related factors on nurse practitioners’ and physician assistants’ views on quality of primary healthcare in the United States. Applied Nursing Research : ANR, 27(3), 152–156. http://doi.org/10.1016/j.apnr.2014.01.001
After reading through the case study, there is definitely some figuring to think about. In all honesty, I would feel that the 24-patient-per-day salary is what I would propose for, because of many reasons. Where I currently work as a RN in the Emergency department, we occasionally float to the urgent care to work. This is a rural hospital, but it is a very busy facility. During the winter months, it is not uncommon to see upwards of 60 patients in a 12 hour period. This is definitely a large patient load for 2 nurses and one nurse practitioner. I have worked in that setting, and seen the struggle that it can be, but 24 patients in an 8 hour setting is 3 patients an hour, on average. The AANP suggests that the majority of nurse practitioners see 3 or more patients an hour (AANP, 2018).
To be honest, I would want to suggest a higher salary if I was applying for a position in an urgent care such as this one. If I was seeing 60 patients a day at $56 per patient visit, I would be bringing in a revenue of approximately $870,000. This is nearly 3 times as much as a 24-patient-per-day nurse practitioner. Granted, this is for 24 hour shifts, where the 24-patient-per-day is more than likely an 8 hour day. The nurse practitioner may treat four or more patients per hour throughout the entire work day in an urgent care setting (n.a., 2016). Working in the urgent care doesn’t have the luxury of having a schedule, so the amount of patients that you may see could be greater or lesser than 4-per-hour. On average, it will all even out. I think that when determining salary, it matters where they anticipate you to be working. I would like to work in an urgent care versus a primary practice, so I would want to have a higher salary than what the 24-patient-per-day nurse practitioner proposal states.
AANP, (2018). NP Fact Sheet. Retrieved from https://www.aanp.orgLinks to an external site. n.a. (2016). How many patients should FNPs expect to treat per hour. [Web log post]. Retrieved from https://www.midlevelu.comLinks to an external site.
Wow, the information Buppert (2011) presented in the above discussion, regarding the income an NP bring home after all bills are paid was eye opening! I can see how establishing a salary for a NP can be challenging. Even with the information Buppert (2011) present, when I determine the salary I desire to earn I would consider the National Salary Survey of Nurse Practitioner conducted by ADVANCE, the geographic area, and the average APN FNP during that time. I also think it would be a great ideal to network and speak with other ANPs within my areas to get a better understanding and ideal for what is common when negotiating. I’m sure with any job or career salary is a sensitive topic for the employee and employer but it is a topic that has to be clear and address. According to Danielsen, Potenza, and Onieal (2016), regarding salary and bonus compensation can be either objective (production based), subjective (entirely up to the discretion of the employer based on internal criteria) or both. Regardless of the system that is used it is critical that NPs have a clear understanding on what is expected and what the rewards are for meeting those performance expectation and goals.
Because this will be a contract renewal I would propose a higher salary than the previous two years of service but a salary that is within expectation/limits for the practice. I do believe that what is most important is that the expectation and desired salary is reasonably and realistic.
Reference
Danielsen, R. D., Potenza Ll, A. D., & Onieal, M. (2016). Negotiating The Professional Contract. Clinician Reviews, 26(12), 28-33.
According to the Bureau of Labor Statistics (BLS), the average NP salary is $107, 460. As of April 2018, Salary.com has listed the average NP salary in Georgia as $93, 346 (low) to $102,049 (high). I am used to handling a heavy patient load, so I would consult at least 24 patients per day. I would establish my salary based upon two conditions: how long I plan to stay with the organization and what the average NP salary was for the area in which I work. For example, I would ask for a higher salary if I worked in the City of Atlanta versus the small town of Columbus, Georgia. If I plan to stay with the organization and seek a contract renewal once my initial contract was up, I would ask for a little less no matter what area of Georgia I work. This means I value the organization and want to leave salary room for a raise. I do not want to cap out because I will have to find another job that meets my criteria. Keeping the BLS salary and the salary.com figures in mind, I would ask for $97,000 annual salary. An NPs salary is indicative of the investment the NP made in his or her career and his or her level of skill/ expertise; years of experience means I can command a higher income (Dillion & Hoyson, 2014). Besides, as a professional nurse who has earned a master’s degree, I should make no less than $46.12 per hour (Dillion & Hoyson, 2014). A nurse, especially a nurse with a higher degree, can never be compensated for what they are worth—but they can sure come close. Nursing is long, hard, back-breaking work. It is mental and emotionally taxing. Nursing is a calling, but this does not mean we should not be compensated. Nurses invest a lot of money and time into becoming invaluable medical professionals. The nursing shortage is real. If nurses are worried about paying off school loans, driving unreliable cars, and unable to comfortably take care of their families, no amount of love for the profession or their patients can get them to stay.
References
Dillion, D., & Hoyson, P. M. (2014). Beginning employment: A guide for the new nurse practitioner. The Journal for Nurse Practitioners, 10(1), 55-59. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2013.09.009
I can understand my employer’s concern about me not seeing enough patients; however, there is nothing I can do about patient traffic since I do not book patients. Weirdly, this falls under unrealistic employer requests. My genuine mindset is, patients will call in for appointments or they do not. Also, booking patients is the job of the office manager or patient consultant. However, I also understand the necessity of me being a team player and fostering interprofessional teamwork outside of a clinical setting (Poghosyan, Norful, & Martsolf, 2017). I want to avoid offending my employer, so I can suggest the office manager or patient intake nurse make a follow-up call to all patients to check on their health statuses—this way the office person can “suggest” a visit if the patient mentions any serious health concerns. I am not an advocate of patients getting a checkup every time a tweak or an uncomfortable feeling arises. But, this is a good way to catch up with patients and prompt them to book the NP to conduct a preventative or wellness exam. I can also suggest the employer make use of my other nursing skills. I can review patient charts and make health-based suggestions/interventions; I can pass out my employer’s information at health and community fairs. I can also create an infographic or ppt about patient information the employer can use later to assess services and satisfaction of services among patients. NPs are trained and skilled in many areas of nursing to include office and computer-based work; diagnosing patients and administering care are not the only skillsets NPs have (Poghosyan et al., 2017).
References
Poghosyan, L., Norful, A. A., & Martsolf, G. R. (2017). Primary care nurse practitioner practice characteristics: Barriers and opportunities for interprofessional teamwork. The Journal of Ambulatory Care Management, 40(1), 77–86. Retrieved from http://doi.org/10.1097/JAC.0000000000000156
I have actually thought about this recently when I was looking to get an appointment with my PCP. His schedule was very full and I was not able to get in with him for a couple of weeks. The scheduler offered me an appointment with the PA first thing in the morning for the next day, or one of the other doctors in the practice later that day. Of course I wanted to see my doctor, but I took the PA appointment. I have heard patients in our ER ask why they were seeing a PA or NP instead of a doctor and I think there are a fair number of patients who will always prefer an MD. I feel that the schedulers are in a position to “talk up” scheduling patients with the NP who may have a schedule that allows for more appointments. Schedulers should be educated on the role of an NP and how to respond to patients that may make comments about not seeing the NP. That is one small suggestion. Some other ways to increase overall appointments would be to have the NP’s name listed on the door along with the MD’s who work for the practice. This way patients coming to the office see the NP as a provider, not just as support staff. The NP’s business card should also be included where the MD’s cards are. I think this works as good advertising as well. In my case I was offered an appointment and I remembered seeing the PA’s name on the door quite awhile ago. It made me think that she must be a good provider if she is still there, and she isn’t
When I chose my current job, I took whatever salary I was offered to me because I wanted the job so badly. It was the standard contract salary for all the new nurses fresh out of school. After seeing newer nurses with less experience come in making more than me, I am curious to how the hospital or nurse negotiated that. I always knew that Nurse Practitioners made more money, but I never researched salaries or considered the higher pay as part of my choice to go back to school. As a newer, inexperienced nurse that takes fewer patients, I would expect to make less. As I start to gain confidence and see more patients, I need the skills to negotiate a higher salary. Research has also shown that NPs make different wages based on specialty setting and other social factors (Greene, El-Banna, Briggs, & Park, 2017). A 2017 survey of Nurse Practitioners showed the average salary for a female NP was $96330 (Greene et al., 2017).
If I were seeing about 20 patients a day at a 90 percent collection rate, I would expect the average salary of the 15 patient and 24 patient NP. 103,000 sounds like a reasonable take-home salary for my patient load of 20 (Buppert, 2011). This salary is slightly higher than the average NP salary, but I could also show my boss salaries from the state and my specific specialty to back up my request. I would have realistic goals and expectations. There has been a shift in PCP pay based on performance and patient experiences (Gannon & Becker, 2013). As a future FNP, I have a role in transforming healthcare and giving my patients better care experiences. ACNPs have strong communication skills, improve work culture, and decrease Emergency Room visits (Gannon & Becker, 2013). Patients treated by NPs perceive better care and give higher scores on HCAHPS, leading to better Medicaid reimbursement (Gannon & Becker, 2013). With higher reimbursement rates, I deserve at the minimum the national average for pay, if not more for my patient load.
Greene, J., El-Banna, M. M., Briggs, L. A., & Park, J. (2017). Gender differences in nurse practitioner salaries. Journal of The American Association of Nurse Practitioners, 29(11), 667-672. doi:10.1002/2327-6924.12512
Buppert, C. (2011). Nurse practitioner’s business practice & legal guide. (4) Gannon, W. D., & Becker, D. (2013). The acute care nurse practitioner and the transition to pay for performance. Journal for Nurse Practitioners, 9(4), 249-251. doi:10.1016/j.nurpra.2013.01.014
I can relate to you so well. When I was a new nurse, fresh out of school I was so excited that I settled for any offer just because I was able to work as a new nurse in the ICU. However, as time went on I started to see new nurse come on with no experience making more than myself that became a little disturbing. However, after reading and participating in this discussion, it makes me wonder should I have negotiated my offer. It also makes me wonder if I should discuss my current pay rate with my manager during my annual evaluation/performance. For my future career as a FNP, I did not consider the career path as a FNP related to the pay for FNP when I decided to return to school but I knew that NPs made a higher salary. I know that many people may feel that research is irrelevant, but this is a great case, discussion where research can play a critical role with evidence-based facts to support or request a higher pay or a reasonable pay. It will be hard to argue or disagree a request for a desire pay with research as the supporting data. Many healthcare organizations strongly encourage the use of EBP and the use of EBP with a request for a higher pay would be a great.
Signing a new or renewing contract salary is a delicate issue that the NP’s need to pay attention to. It is essential to know what your worth and average salary you are eligible to receive. Understanding the terms and conditions of the contract are vital to avoiding conflict. The first thing that needs to be known is what the state salary averages are. My base salary should be based on her geographic area averages (Taylor, 2007). If my base salary for 24 patients is $127, 699 then by calculations (127,699 divided by 24 times 20) a base salary for 20 patients would be $106,415 (Buppert, 2011). Nurse Journal.org has a great salary by state webpage that is very helpful in determining median averages (Nurse Practitioner Salary by State, 2015). Since I would be new to the practice suggest asking for a salary close to the previous calculations. I would negotiate for a base early salary of $110,000. However, I believe it is possible to see 24 patients per day and would opt to negotiate this and thus ask for a base yearly salary of $130,000.
Your work ethic will induce the decision maker to renew your contract and give you what you are asking for. Be prepared to show the performance and the quality of your services such as patient satisfaction, increasing in repeat customers, decreasing of no-show appointments, and gain of additional patients. A good reputation is an important asset for the practice. High levels of patient satisfaction attract more patients which translate to more business for the practice, consistent profitability and more revenue (Shirley, & Sanders, 2013).
Buppert, C. (2011). The employed nurse practitioner. In Nurse practitioner’s business practice and legal guide (4th ed., pp. 319-320). Sudbury, MA: Jones and Bartlett.
Nurse Practitioner Salary by State. (2015). Retrieved from http://nursejournal.org/nurse-practitioner/nurse-practitioner-salary-statistics/Links to an external site.
Shirley, E. D., & Sanders, J. O. (2013). Patient satisfaction: implications and predictors of success. J Bone Joint Surg Am, 95(10), e69. doi: 10.2106/JBJS.L.01048
Taylor, L. (2007, March 6). Contract negotiation. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Contract-Negotiation-2.aspxLinks to an external site.
Numbers don’t matter if our patients aren’t satisfied with the care provided. While a provider can start with high numbers, these numbers will drop as satisfaction decreases. A lot of dissatisfaction stems from feeling like a number rather than a human being. This doesn’t necessarily relate to time spent with the patient but the patient’s feeling of being rushed in and out of the room. Even when we are behind and in a hurry, we still need to act like we are running on time and have all the time in the world to spend with each patient. There are times where I may be 45 minutes behind and while I am trying to get out of a room to get to the next patient I make sure to focus on the patient I am with, answer all their questions, and redirect any conversation that is not imperative in a polite manner. I never tell a patient I don’t have time to discuss something because I have patients waiting. That statement will cause you to lose patients. I usually just find a way to redirect the conversation if it is not something we need to address right then. Sometimes this is as simple as saying, “Let’s get you feeling better first and when you return in one week we can address that issue”. This lets the patient know you heard them and understand they have more issues and that they will be addressed but that there are more important issues for that patient that need to be addressed first. This allows you to try to get back on time without making the patient feel as though he is part of a cattle mill. Of course, when your patients get very familiar with you and request seeing you, they usually understand when you are running behind and have no problem with it. Often times, they will say they understand and they know that when they need the extra time with you, they know you will take that time without it being an issue.
As the Clinical Advisors 2017 Salary Survey reveals, roughly 54% of physician assistants (PA’s) and 55% of Nurse Practitioners (NP’s) show a higher income than they did previously in 2015-16, marking this as a beneficial time to ask for a raise (Salary Survey, 2017).
The gender pay gap still remains between men and women in all areas of the workforce, and unfortunately the healthcare field is no exception to this problem. Among the total of 2136 NP responders, male NP’s earned $123, 547 compared to $104,097 for their female counterparts. Male PA’s earned $128,966 while the female PA’s earned $107,957. In addition, the Western area of the U.S. remains highest in compensation for both PA’s ($123,875) and NP’s ($113,035). The average salary in the South for PA’s is $114,302 and NP is $104,427. The Northeast holds the lowest salary for PA’s at $110,702, and the Midwest holds the lowest salary for NP’s at $102,571 (Salary Survey, 2017). Of course, continued variations will remain based on specialty areas such as surgical, pediatrics, cardiology, neurology or other such areas.
Being that I reside in the Midwest (within the suburbs of Chicago), I unfortunately live in the area with the lowest average salary for NP’s, however I would still offer such statistical averages to my benefit in hope of retaining an increase in salary during contract negotiation. Using the salary of $88,638 for the 15 patient per day NP as an example, I would propose a 5% increase of %93,070. I feel this would be a fair increase in salary, given the average salary rates and benefit that myself and my role would offer to the practice in terms of practice revenue, decreased work burden of the physicians, as well as continuity of care and patient satisfaction for the patients whom trust the practice with their health care.
SALARY SURVEY. (2017). Clinical Advisor, 20(9), 52.
The gender pay gap between male and female nurses is an issue you address in your post that I would also like to address. Your stats were very helpful, and they got me thinking about how gender issues also play a role in the perception of NPs. I do not understand why a profession that employs close to 90 percent women pays male NPs more money. NPs of all specialties have the same responsibilities regardless of gender. A male FNP should not be paid more than a female FNP unless he has more credentials like a doctorate while the female NP has a master’s degree or more experience like he has been on the job 20 years versus her 10 years. I am not stating that female NPs should make more than male NPs; I am saying that pay should be equal across the board for the same position, years experience, degree, etc. After doing some basic research, I could not find any reason why male NPs make more than female NPs when the background and experience are the same other than employers traditionally pay men more money for the same job positions women assume. This issue occurs in almost every industry. Greene, El Banna, Briggs, and Park (2017) analyzed the relationship between gender and salary among NPs. They have concluded that experienced male NPs earn $12,859 more than female NPs, and recent male NP graduates make $7405 more than recent NP female graduates. This financial gap widens over time. Greene et. al (2017), agree gender disparities in NP salaries should encourage healthcare organizations to conduct pay equity assessments to identify and amend unequal pay issue.The way to address inequality in pay is to advocate for legislation to eliminate gender pay gaps in nursing. Period!
Reference:
Greene, J., El-Banna, M. M., Briggs, L. A., & Park, J. (2017). Gender differences in nurse practitioner salaries. Journal of the American Association of Nurse Practitioners, 29(11), 667-672. Retrieved from doi: 10.1002/2327-6924.12512
As Nurse Practitioners and revenue generators it is important for the NP to be conscious regarding the worth of his/her work and his/her worth to the practice when deciding and proposing a contract renewal agreement. Being aware of the what the NP has to offer will allow for negotiations of salary and benefits and can serve an evaluation tool to measure the NP’s productivity as well as a motivator to further increase revenue.
If the Nurse Practitioner sees 20 patients a day at $56 per patient visit she/he would have a revenue of $1,120 per day and $257, 600 a year, yet with a 90% collection rate the Nurse Practitioner would be “worth” $231,840 yearly to the practice (Bupert, 2011). In addition to this estimated revenue the Nurse Practitioner also takes call every third weekend. Furthermore, estimating productivity and value is an important aspect of every business especially in healthcare. According to Pickard (2014), finding ways for maximum productivity from each healthcare provider is essential for financial survival in the healthcare field (Pickard, 2014). Knowing the value of your practice and what you bring to the table allows for negotiation of salary, benefits and further responsibilities and independence in practice. Furthermore, productivity measurement allows for accountability, efficient management and promotes transparency (Pickard, 2014). Once calculating the revenue that is made it is important to keep in mind that considering being a 1099 FNP, that you will be paying more in taxes and all in your own it is important to take that into account when deciding on a salary. Normally since taxes are not taken out and benefits are not received there is about 20-30k added to the salary that would normally be paid.
Based on estimated revenue the Nurse Practitioner contributes to the practice, the additional on call responsibilities and the physician’s plan to produce more revenue for the practice I would propose a salary of $115,000 for the contract renewal. The proposed salary is based on the current generated revenue and responsibilities of the Nurse Practitioners. In addition, I would propose that if the practice continues to grow and increases its revenue the Nurse Practitioner be re-evaluated in one year, therefore, reconsidering the NP’s compensation and benefits based on his/ her services, productivity and value. According to Pickard (2014), volume, costs, work effort, and revenue are all significant factors when measuring productivity (Pickard, 2014). Value on the other hand is based on efficiency, quality and patient satisfaction (Pickard, 2014).
References:
Buppert, C. (2011). Nurse practitioner’s business practice & legal guide (4th ed.). Sudbury, MA: Jones and Bartlett
Pickard, T. (2014). Calculating Your Worth: Understanding Productivity and Value. Journal of the Advanced Practitioner in Oncology, 5(2), 128–133.