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Someone I spoke with today told me that pain management NP's are making >200k/year. Is there any truth at all to this? It just sounds too good to be true...
NP salary question
- Thread starter futurepsych0
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Someone I spoke with today told me that pain management NP's are making >200k/year. Is there any truth at all to this? It just sounds too good to be true...
I can't say for sure whether that's true or not, but it wouldn't surprise me. Pain management coupled with addiction medicine can be a cash business where people are willing to pay. Low overhead, high reward potential. Might not be the easiest thing to deal with folks in pain and drug abusers day in and day out. Telling someone that you are tapering them off of their favorite substances and having them get upset doesn't sound fun to me, even for 200k. But it doesn't at all sound like its outside of the real of possibility that an NP is out there doing it for that, especially if they are working for themself.
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Yes. But I believe it's an attainable outlier, as well as an outlier that reflects the fact that most NPs don't choose to tread their own path into practice ownership. Over at allnurses forums, there are NPs easily making 150k because they are part owners of practices, and they have decent hours and working conditions. I doubt that working as an employee for a physician you would be offered such generous wages. Even if a practice owner were to offer an NP 130-150k, that would be enough to make for a happy NP. I think a physician would see more logic in compensating an NP 60k less and use the difference to buy his wife a new car and a vacation to Europe.
However, the NP making that kind of money also is on the hook for expenses, taxes, billing, overhead.... And all the headaches associated with running a business. Most NPs forgo that route and do what PAs do... Go work for a physician or group. But the interesting bell curve to see would be the one that shows how much independent NPs make. That would be more telling. An NP in pain management for a physician would probably make what an NP would under most other circumstances.
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deleted6669
are they crna's? I know some working in pain clinics who make this...very different skill set than fnp's
Nah.... There's an NP cert in pain management. Also, google pain management NP and you get tons of job listings.
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If its a FNP or PA it's a pill mill I would assume. There was a job down in Texas offering that(225k) and with a little research I found it to be a pill mill.
Crna I don't know anything about. As far as PAs if your not making 110k-120k at least then you didn't look hard enough,....or limiting yourself geography wise too much
Crna I don't know anything about. As far as PAs if your not making 110k-120k at least then you didn't look hard enough,....or limiting yourself geography wise too much
Plenty of dcotors are pill mills themselves.
To me, pain management sounds like a terrible place to be. Imagine taking your more difficult behaving patients from other settings and making that your bread and butter enterprise. Even if 95 percent of your folks were easygoing, that 5 percent would make life hell. And i think assumin 95% of your patients being "nice" would be a conservative estimate. The way into even the legit peoples hearts is to drug them up to some degree. Not fun.
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deleted6669
occ med would be the same....not only would they want narcs they would want you to file disability paperwork for them....
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I have noticed that, in terms of job openings for pain management NP's to work for doctors/hospitals, most job openings specify that the practice wants to hire only an NP. This is even the case in my area of the southeast, where there are plenty of PA's working in all other fields of medicine. I don't live in an independent state, so why are only NP's being hired to work in pain management? What's the advantage for the practice?
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deleted6669
1.not too many PAs are interested in pain management
2. if they become a pill mill the doc/practice owners want to be able to say they were "out of the loop".
hard to do that if they are required to sign off on 10% of a PA's charts...." The NP was required to collaborate on difficult cases but never told me Mr. Jones was getting 200 2 mg tabs of dilaudid every 2 weeks for his chronic, nonmalignant little toe pain of 20 years duration"
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Thanks. So even in a non-independent state, the NP still doesn't have to have their charts signed-off by a physician?
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So more NPs vs PAs are interested in pain management? Why?
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deleted6669
it's generally done on an outpt basis and most PAs today work in specialties, many of which are inpt.
also, have you ever worked in pain management? it's a great fit for "kinder/gentler/holistic" practitioners....
I'd think the holistic folks would be pushing alternative therapies than overprescribing pain meds.
You see plenty of PAs doing pain medicine, occ med, and other stuff of that nature. Being a PA doesn't make them too highbrow to fall under the spell of easy money, especially in a tightening market.
On of the more sketchy things I knew about was a chiropractor that hired an NP to make it so they could use Botox in their "wellness spa". The NPs independance licence allowed administration of products that a chiro would never be allowed to use. So in other words, the chiro was paying the NP to risk the NPs licence and extend credibility to this "clinic". 1500 bucks a week was the what the chiro paid, so it must have been well worth it to pay out that kind of money. The nurse pretty much did nothin but risk a hard earned licence so the chiro would be legit doling out Botox. Dumb move.
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Well, until the holistic/alternative therapies don't work. Then it goes to narcs, because they make ya feel a little good all over.
That's true... I'm not touting complimentary therapy, just saying that you don't have to be an NP to overperscribe. If anything, the NPs that are liberal with issuing drugs are probably like that less because they are "holistic", and more because we administer pain meds as part and parcel of our RN role (more so than using holistic care). If anything, then maybe NPs might argue they have a few more tools in their belt than folks in the medical model. But there's no reason to single them out as pill pushers by saying they are touchy feely. What've reason for their penetration in to pain med (if they indeed are beginning to dominate) probably has more to do with independance being appealing to docs. PAs might be in the exact same place if they were independent.
NPs are just like any other provider who gets approached by patients in pain.
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deleted6669
I think my point regarding docs being able to disavow/not be responsible for the performance of the np actually has merit. docs often think they are less responsible if they don't sign the chart. my understanding is that they are not. if it is their clinic regardless of who works there(doc/pa/np) the clinic owners share some liability for anything that happens inside the doors of their place.
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deleted6669
true, but the reality is that in most situations NPs control the outpt market and PAs control the inpt market.
sure a pa can get into outpt pain med, just like an np can get into surgery or em. it's just less likely.
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Alright, here's another one of those "is this too good to be true?" questions, LOL. I was talking to one of my nursing school classmates earlier today, and she was saying that NP's who work in wound care doing home visits can start out earning $115-120k/year and are reimbursed for gas mileage. Does anyone know if those statistics are common? Do most positions involving home visits not include benefits? I figure there has to be a catch somewhere...
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Not sure if that is true but that would be a terrible job. Especially if that is all you did.
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Now I have no first hand experience in healthcare so my answer is based strictly on research. First, salaries vary A LOT depending on location. The salary figures linked in my original thread are national averages and low compared to big cities. I know of one NP who works in an infectious disease clinic and makes 130k (cost of living is also high here). She works mon-fri is always home by 5 and is never on call. So I personally don't see thr salary you quoted farfetched. The latest salaries (for 2013) done by indeed can be found here http://salarybystate.org/healthcare/nurse-practitioner-salary-by-state it breaks things down by state but doesn't account for specialties. That was really the crux of my OP because I noticed NPs are usually paid about the same regardless of what specialty they work in. Also, if I were to base my salary expectations on something I would try to go by state average and not anecdotal salaries. I hope this helped.
It wouldn't surprise me to know that home visits could be lucrative, but like others have said, it might be a job that isnt appealing. I think I'd rather work out of a location with resources on hand vs out of a car.
Most NPs I know do well, regardless of what they do.
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That's essentially what I've heard, too. I actually got in touch with an RN (not an NP) who works for one of those home health agencies doing wound care visits, and she said she actually earns $80/hour working on a new patient and $50-55/hour revisiting one. If the RN's are doing that well doing that kind of work, then I figure NP's are doing pretty darn good...
Where I'm at they don't make that much in home health (although you can make a lot), but there is plenty of money in home health and hospice type work... Because it can be difficult. You have to be the right kind of person for that or you won't last long. In some places, though, RNs actually do about as good as NPs and PAs, so don't get fooled thinking that it automatically provides more income to be a provider. RN department heads can make 90k easy. The reason i know this is i know a few department heads that are also NPs... That wouldnt be the case if they werent doing better than they would be practicing as NPs. In my area there are plenty of NPPs, and it's driven the wages down a bit, and doctors have their pick of providers, so you dont see them having to throw bennefits at them. As a floor nurse for a hospital, I have better bennefits and PTO than many NPPs, even though they can make more in wages. I pity folks working for salary 50+ hours a week, which you can easily see in the nonphysician provider crowd in a desirable location.
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Wow, I didn't know that there were RN's who are out-earning NP's. I figured it would always be the other way around. At least, I'm sure it's the other way around here in my area -- I'm currently enrolled in a nursing program, and the starting salary in my area for new-graduate nurses is just shy of $20/hour. Most of the job ads I've seen for PA's/NP's locally are offering at least $85-90k to start (obviously, I don't live in what most would consider to be a "desirable" area).
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deleted6669
last time I checked the figure of NPs practicing as RNs on the west coast was around 50% because after 2 more yrs of school folks figured out they could make more as a charge nurse, dept. manager, etc using their rn than they could as an entry level np. my current ER has 3 NPs working as RN's. my last ER job had 2.
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I know a guy who graduated last May from a nursing program and was set on becoming a CRNA, but he took an offer to work as a charge nurse for his first job (he was attracted to the money -- I think they offered him around $33/hour), and about 4 months later, he was promoted to the position of head/lead charge nurse. I believe he makes over $100k now. According to him, the next promotional level is assistant or associate nursing director, and at that point, he will earn close to what a CRNA earns. On top of that, he just has his BSN -- once he attains the online MSN he's working towards, he will earn a pay raise (regardless of what position he's working). So instead of going back to school in a couple years to become a CRNA, his plan at this point is to just keep moving up the ladder and make essentially the same amount of money in just a year or two.
emedpa, let me ask you a question -- since most practices hire both PA's and NP's interchangeably, aren't they being offered the same pay/benefits packages? If so, then isn't the pay situation that is currently affecting new-grad NP's (the fact that they earn less than they would as an RN in a managerial role) also affecting PA's? In other words, aren't PA's starting out at the same low salaries in many areas (such as the west coast, as you mentioned)? Of course, I guess the difference for PA's is that, since most PA's weren't nurses before becoming PA's, they can't really fall-back on their previous education in the same manner...
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deleted6669
the pay and benefits packages are the same but the pay isn't really that bad. the difference is 45 dollars/hr to start as a new grad pa/np vs 60/hr as an agency nurse(without benefits but you can buy a lot of bennies on 15 bucks/hr).
In my neck of the woods there just are not as many hospital based jobs for NPs as there are for PAs so an NP wanting to work in surgery or em pretty much has to either move to a more np friendly area or work in those specialties as an rn.
nurses looking to move up the admin ladder should get both the msn and an mba. hospitals love that. many nursing directors have jane doe RN, MSN, MBA on their name tags.
some PAs do still work in their prior fields. the difference is that today most PAs are not former nurses so their prior careers likely pay less than their new grad pa careers. that being said, I have friends still working shifts as medics(for the love of ems mostly), occupational therapy( @ 50/hr per diem), and as hospital nutritionists.
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There are no less a few dozen RNs in the state of California who make upwards of 300k (they are listed in online database of public employees). Of course, they work in ****ty prisons and you have to be high up in the union mafia to even get that kind of job, but it is out there.
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deleted6669
Most of that is overtime. the lady who made the most last year worked something like 80-90 hrs/week in a state prison with 40-50 of it as overtime. yup, that's a lot of money but at that point you are working 2 full time crappy jobs. I know PAs making 250k/yr. same deal. they work 26 days/mo and have no life.
Blend what you said and what emed said into one, and you have the right idea about the California RNs making that kind of money. Those are folks that are burning the midnight oil, as well as people who are high up in seniority that are required by union agreement to have first dibs on any overtime. And California is a very unique market. If you can manage to break into it, then you are in good shape. However, jobs there can be tight. I know a couple who are both nurses and made the jump down there 5 years ago, and they are swimming in money. But thats CALIFORNIA. I have a med tech degree as well as nursing, and California has some of the most onerous rules in place that make relocating to there from out of state... to the point where its almost impossible. But if a medtech can pull it off, they are looking at similarly inflated wages. And the place is in financial meltdown anyway.
