[NP-Clinical] contracts and negotiating for a new clinic

Carla Anderson carla_rayne at yahoo.com
Mon May 14 11:26:17 PDT 2007 

Hi Paula,
   
  I think it looks like a great opportunity.  Carolyn Buppert also has a book on Productivity based incomes for NPs. I would start out with a contract, with maybe 50.00 an hour for the first 90 days, and then add in a percentage as you see how much contribution you bring in to the clinic. You can also decide about malpractice, cme money.  It depends on number of providers, your overhead, etc.  Normally it is desired that the NP brings in 3x what they get compensated, so that covers the overhead, and the NP salary/% of reimbursement, and also the clinic profits. Say that you agree, that anything you bring in reimbursement over 3 x your wage, you get 20% of what is over 3x. For example, you work 8 hrs at 50.00 an hr. This = 400.00.  You bring in 1200.00 that day. Anything over 1200 reimbursement, you get an addl 20% of that.  So say you bring in 1500.00.  So you would get your normal 400.00 hourly wage, plus 20% of what is over 1200 (300.00) = 60.00.  So for that day you
 would get 460.00.  Hope that makes sense. Carla

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Today's Topics:

1. RE: contracts and negotiating for new clinic (Marilyn Dean)
2. Re: Re: [NP-Clinical] Resparate device for BP control.
(pattinp at verizon.net)
3. spirometry (Sue Wiers)
4. Re: spirometry (Erich Widemark)


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Message: 1
Date: Mon, 14 May 2007 07:02:18 -0500
From: "Marilyn Dean" 
Subject: RE: [NP-Clinical] contracts and negotiating for new clinic
To: "NP Clinical" 
Message-ID: 
Content-Type: text/plain; charset="iso-8859-1"

Dear Paula,
My advise is ask for a baseline you can live with and have a bonus in place.
What kind of fringe benefits do you want? If you are an employee you will
make your employer money, maybe not the first year, but definately as the
volume increases. This has worked well for me. When I see people that are
working hard and building up a practice and their employer gets most of the
benefit it makes me unhappy. You will be a better employee if you are a
happy employee. Also make sure you can see your productivity and totals each
month. It is great incentive to see that extra person, you'll feel confident
that things are being done fairly, and that is just a professional way to
have your employer treat you. I know it isn't all about the money, but some
of this is being treated in a respectful manner. I almost guarantee if you
don't ask for it you won't get it. I put in long hours, love what I do, and
am fairly compensated, but it didn't happen without me knowing what I
wanted.
Marilyn Dean


-----Original Message-----
From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]On
Behalf Of Alfredo Bimbela
Sent: Sunday, May 13, 2007 1:40 PM
To: NP Clinical
Subject: Re: [NP-Clinical] contracts and negotiating for new clinic


Hi Paula,

My 2 cents:

1. Make sure the contract language allows for future negotiations either
by time and/or profit margins. As your contribution and effort leads to the
successful recruitment of patients, clinic growth, and financial stability,
your financial gain should be growing as well. Nothing more frustrating than
working your butt off and then being told that further negotiations will
need to be deferred for a later time. Don't rely on verbal assurances that
sound like "we can always revisit and change the contact later as business
picks up".

2. Make sure the contact answers the question: "What happens if the
clinic/business does well and then the physician says that my salary and
contact are fine?"

3. While you can certainly accept reasonable terms now that reflect
start-up costs and low patient volume, consider including into the contract
phrases that will reflect growth and revenue. This is based on the thought
that the clinic will do well over time.

4. I agree with Priscilla about finding out why the PA quit.

Alfredo

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Message: 2
Date: Mon, 14 May 2007 08:09:35 -0500 (CDT)
From: 

Subject: Re: Re: [NP-Clinical] Resparate device for BP control.
To: NP Clinical 
Message-ID:
<32257257.3644281179148175966.JavaMail.root at vms071.mailsrvcs.net>
Content-Type: text/plain; charset=UTF-8

Dave,
Thanks for your thoughts. I will contact them and talk with about what we do.

Patti

>From: David Mittman 
>Date: 2007/05/12 Sat PM 09:31:07 CDT
>To: NP Clinical 
>Subject: Re: [NP-Clinical] Resparate device for BP control.

>Without speaking for them, I would say they were very open to learning about
>NPs and PAs and very open to treating us the same way they treated
>physicians. This device was developed in Israel and has much use in Europe
>also. They really did not come to the states knowing our role simply because
>they do not really have others us like we are in other countries. They have
>been open to learning and have an NP,PA on their speaker's bureau which is
>quite small. As I said they are a good company that cares about people.
>Dave
>
> On 5/12/07 9:30 PM, "pattinp at verizon.net" 
wrote:
>
>> Dave,
>> It will be interesting to hear what they say. When you consulted for them, how
>> did they envision working with NPs and PAs? I would be really interested in
>> knowing. I am currently working as the primary Medcial Provider in the
>> Occupational Health Center at the US Patent and Trademark Office in DC. We
>> have 8000 employees and HTN is a hughe problem primarily because of the stress
>> placed on patent examiners to produce. As I said I have given the
>> informational page to quite a few patient referring them to the Resperate web
>> site.
>> 
>> Patti Robertson
>> 
>>> From: David Mittman 
>>> Date: 2007/05/12 Sat PM 03:28:01 CDT
>>> To: NP Clinical 
>>> Subject: Re: [NP-Clinical] Resparate device for BP control.
>> 
>>> Patti: POINT WELL TAKEN.
>>> I have asked them by email one minute ago to review the website and make
>>> appropriate changes. I am sure they will.
>>> Thanks for pointing it out.
>>> Dave
>>> On 5/11/07 9:10 PM, "pattinp at verizon.net" 
wrote:
>>> 
>>>> Dave,
>>>> Since you have done consulting with them, in what way do they want to work
>>>> with NPs and PAs? When yu go to their website the form you download for
>>>> free
>>>> 8-week trial is for physicians to fill out. If they want us to recommend it
>>>> I
>>>> suggest they change the wording.
>>>> 
>>>> That being said, I spoke to a physician who personally has used this machine
>>>> for his BP. He said that it has lowere his systolic 15 mmHg and diastolic 10
>>>> mm Hg. So I have been recommending it my patients especially those who are
>>>> adament about not wanting to take medications.
>>>> 
>>>> Patti NP of VA
>>>> 
>>>>> From: David Mittman 
>>>>> Date: 2007/05/11 Fri PM 04:13:51 CDT
>>>>> To: NP Clinical 
>>>>> Subject: Re: [NP-Clinical] Resparate device for BP control.
>>>> 
>>>>> Re: [NP-Clinical] Resparate device for BP control.Paula: I have done
>>>>> consulting for this company and this device is based on sound studies and
>>>>> really has a place in the treatment of hypertension. They also want to work
>>>>> with NPs and PAs.
>>>>> They are good.
>>>>> Dave
>>>>> 
>>>>> � On 5/11/07 1:42 PM, "Paula Sumner" wrote:
>>>>> 
>>>>> Hi, have you seen this ad or used this product? It sounds like a
>>>>> biofeedback
>>>>> device, but of course, being touted as a medical device. � There seems to
>>>>> be
>>>>> an opportunity to sell these or rent these from the office. Paula
>>>>> � � 
>>>>> � 
>>>>> � � 
>>>>> http://www.resperate.com/clinician/sample/program.aspx
>>>>> 
>>>>> 
>>>>> Paula J. Sumner RN, MSN, HTP, CHt
>>>>> Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
>>>>> 3500 Westgate Dr., Suite 504-G
>>>>> Durham, NC 27707 � (now Carborro too.)
>>>>> 919-490-4656, 8#
>>>>> 
>>>>> http://paulajsumner.byregion.net � Referral ID#10102918
>>>>> 
>>>>> http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
>>>>> 
>>>>> http://www.letstalkcounseling.com/sites/paulasumner
>>>>> 
>>>>> � � 
>>>>> Sick sense of humor? Visit Yahoo! TV's Comedy with an Edge
>>>>> � >>>>> href="http://tv.yahoo.com/collections/222>">http://tv.yahoo.com/collections
>>>>> /2
>>>>> 22> to see what's on, when.
>>>>> _______________________________________________
>>>>> NP-Clinical mailing list
>>>>> NP-Clinical at nurse.net
>>>>> http://lists.nurse.net/mailman/listinfo/np-clinical
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> _______________________________________________
>>>>> NP-Clinical mailing list
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>>>> 
>>>> _______________________________________________
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------------------------------

Message: 3
Date: Mon, 14 May 2007 14:02:39 +0000
From: "Sue Wiers" 
Subject: [NP-Clinical] spirometry
To: np-clinical at nurse.net
Message-ID: 
Content-Type: text/plain; format=flowed

We are replacing our spriometer and I am trying to get an idea of what to 
buy. We are a two-provider family practice and probably average one 
spirometry a day. Clearly, we do not require a deluxe model, but want to 
buy a good-value machine. Does anyone have any resources or information?

Thanks,
Sue Wiers

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------------------------------

Message: 4
Date: Mon, 14 May 2007 07:40:55 -0700 (GMT-07:00)
From: Erich Widemark 
Subject: Re: [NP-Clinical] spirometry
To: NP Clinical 
Message-ID:
<27815165.1179153656190.JavaMail.root at elwamui-huard.atl.sa.earthlink.net>

Content-Type: text/plain; charset=UTF-8

Our group looked at the combination spirometer and ECG machine by Welch Allyn. They are small attachments that hook up to a laptop. I was quite impressed at both the size and the operation of both.

Erich

-----Original Message-----
>From: Sue Wiers 
>Sent: May 14, 2007 7:02 AM
>To: np-clinical at nurse.net
>Subject: [NP-Clinical] spirometry
>
>We are replacing our spriometer and I am trying to get an idea of what to 
>buy. We are a two-provider family practice and probably average one 
>spirometry a day. Clearly, we do not require a deluxe model, but want to 
>buy a good-value machine. Does anyone have any resources or information?
>
>Thanks,
>Sue Wiers
>
>_________________________________________________________________
>Express yourself instantly with MSN Messenger! Download today it's FREE! 
>http://messenger.msn.click-url.com/go/onm00200471ave/direct/01/
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End of NP-Clinical Digest, Vol 14, Issue 34
*******************************************



Carla R. Anderson, FNP-C
  Healing Presence Family Practice, PC
  www.HealingPresenceNP.com  
  carla_rayne at yahoo.com
  503 819 9726
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