[NPInfo] Yes, you have the power

Thu Feb 8 18:18:14 PST 2007

    How about quitting together...all of you.  I assure you they'd miss your $480 per hour, and they won't be able to find a replacement for all of you.  Oh, they'll be angry and they will acuse you of colusion, but you can ask, "is there a policy against quitting together?"  It will be effective, and you will get an audience.  And you will get concessions.  But if you crack you will all go down in flames.  It is like the colonists standing up to King George.  They had all the power, but only found it when they organized.

       Good Luck,

                   Jeffrey P.

Christine Smith <chrisbsmith at mindspring.com> wrote:
  I think compensation for NPs/PAs is ridiculous too. I make $55 per hour and 
cannot comprehend making less unless my job is lots less stressful. The 
first 4 hours I see uninsured patients as the sole provider in my clinic - 
last night I saw 23 patients in 4 hours. Mostly BS complaints, but still 
require documentation, my time and faking some sympathy for yet another 
snotty nose. The second 7 hours I worked in the ER, seeing more BS and some 
acute pts that actually deserved to be in the ER. I bill an average of $480 
per hour and this is only for my time. It does not include what I bill for 
the hospital, including meds and supplies. It only includes the time I spent 
on the patient, the skills I did include lac repair, I&Ds, monitoring, 
reading x-rays, etc. The patient gets two bills, one from me and one from 
the hospital. My average pt gets billed at $269 (yep, snot noses cost a lot 
if you go to the ER).

Many of the RNs make more than I do and that is distressing to me. I do not 
get night shift or weekend differential though I work minimum of two 
weekends a month and every single night (6pm until at least 2am). The docs 
get a shift differential on nights starting at 7pm but they voted against 
giving NP/PAs a shift differential even though many nights I am there until 
5am saving their ass because the ER is inundated with patients. They just 
started giving us a holiday "bonus" if you work on Thanksgiving, Xmas or New 
Years - $150 per shift. That is not even time and a half like the hospital 
staff gets. The docs all make over $150 per hour. They also get huge 
compensation pay for being on various committees - several thousand per 
month. I get my hourly pay only.

It is unfair and I am not sure how to fight it. I work my ass off, I 
generally have the highest productivity in the dept every month, both in 
billing and in patients per hour. Sometimes it does not seem worth it. 
Interestingly, I could quit my job as a NP at my facility and come back as 
an RN (I know they would hire me in an instant) and be making far more 
money. A PA who I work with is talking about doing this. He is an RN too. 
We wondered if it would send a message to our company that contracts with 
our hospital. Would they care, would they reconsider? Very sad that we are 
not valued by so many of our employers - we are seen as cheap labor.

Sorry, but Megs letter got me going. I am so burned out from seeing every 
runny nose and fever in the county in the last month.

Christine Smith

----- Original Message ----- 
From: 
To: 
Sent: Wednesday, February 07, 2007 6:33 PM
Subject: [NPInfo] Retail Clinics.......Chapter Two

> Retail Clinics....Chapter Two
>
> Tracy Klein's article on Medscape addresses many of these issues and more 
> through a series of tough questions and answers....I have always 
> maintained these clinics need providers with a solid background in primary 
> care, family practice and/or Emergency Dept....then.. skin cancer (etc) 
> won't be missed and appropriately referred to a dermatologist in the area. 
> A good business sense and legal savvy would be helpful as well when one 
> considers being employed by a retail clinic corporation. Review of one's 
> contract before signing is equally as important; Carolyn Buppert helped 
> our group work out details and changes in a contract. Her insight is 
> invaluable.
>
> Compensation for these retail clinics is lower then I had expected and 
> with a seasoned provider working alone for 12 hours, $45-$50 per hour is 
> very reasonable (higher compensation needed for weekends and Holidays) 
> (pay scale: $34-$38 is usual)...consider: if one sees 4-6 people per hour 
> at $59 per visit (baseline)....leaving $300 for the corporation's coffers 
> (+) (-). The clinic overhead is about $100,000 (or so) (probably higher) 
> per year (salaries, equipment, supplies, rent, etc). I also believe 
> compensation across the board for nurse practitioners and physician 
> assistants in many settings is, in a word, embarrassing. Seasoned 
> providers working for $32.50 a hour ( in many clinic settings) when the 
> clinic bills out $600 (+) per hour is intolerable.
>
> I think David Mittman has some very valid and serious concerns providers 
> ought to be troubled about with the proliferation of these retail clinics, 
> how we are being portrayed and the value these concerns should be for all 
> of us.
>
> http://www.medscape.com/viewprogram/5982
>
> Meg (Portland, OR)
> _______________________________________________
> NPInfo mailing list
> NPInfo at nurse.net
> http://lists.nurse.net/mailman/listinfo/npinfo
> ***************************** 

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