Payments for FNP vs MDs

Health
, , ,
1

As a Family Nurse Practitioner who owns her own clinic, it is astounding how hard it is to survive in the healthcare field. Firstly, NP’s are paid 80% out of 100% of what doctors get. We provide the same care but we get paid less. This needs to be changed. We have the same bills to run the clinic as any other doctors office would have, aside for the cost of malpractice insurance being less than a doctor(although it is still extremely high). Then we have to play the insurance game. Our clinic does our best to ensure all documents are detailed to ensure the insurance companies do not need to perform an audit that then results in a loss of payments back to the insurance companies. For example, If I do an annual physical the clinic receives $50.00. Mind you, this is supposedly to cover my front office, MA, supplies, etc. This does not come close to paying me personally, as the business owner. It takes 40-45 min to complete from start to finish. Then, the insurance company has the ability to come back and say we left something out so they are taking the money back. I have seen patients for hypertension, documented it and also documented that the patient wants to discuss weight loss to help with the HTN. Insurance has come back and said they would not pay because it was a weight loss visit. WHAT??! It is ludicrous what they are allowed to get away with this. This, in turn, makes the provider have to see more and more patients in less time. This effects their healthcare clinics and their ability to make a living. I have had pharmacies interfere with what I prescribe, not knowing the patients full history. I have to incorporate self pay alternatives just to break even. Insurance is a complete racket for the healthcare providers and patients.

Another issue is we have to be credentialed by each insurance company to be able to take on the care of their clients. Then we have to deal with them telling us how to care for our own patients. And to top it off we are at the mercy of the insurance companies to even get paid. This needs to stop. Our healthcare is going down the tubes. The many facets us as healthcare providers have to endure to ensure the best possible care for our patients is becoming too much to bare. We cannot keep the doors open in our private practices under these conditions. Hence why so many are selling to the hospitals or retiring. Then the pressure of seeing even more patients is compounded. Meaning the care of the patient is pushed way out the door. This needs to stop!

3 Likes
2

Why dont you just go to medical school then yo get paid 100%? It should be easy then right, because you know so much. NPs were created to be cheap alternatives to MDs to enrich the employer all the while to fool patients into thinking they’re seeing a doctor, and to increase access to care…at the cost of subpar training and far inferior medical knowledge. The cost is your health which is priceless.

3

First off, love how you’re anonymous. Let’s be kind to each other and accepting of different opinions.

Second off, it’s not just “just go to medical school.”

  1. Medical school is incredibly expensive (think second mortgage).
  2. If you go in your 20s, you sacrifice having a family, or you have a family that you never see. Especially if you’re a woman.
  3. You’re also sacrificing years where you’re not contributing to your retirement.
  4. Even if you finish medical school, you’re not guaranteed a spot in a residency program as more physicians graduate than there are spots in residency programs across the U.S.
  5. If you match in a residency, congrats, now you have another four years of working 60-80hr weeks and never seeing your friends and family while getting paid less than minimum wage.

Oh, on top of that, we have a severe physician shortage. Personally, I have to wait three months to make an appointment with my family medicine clinic.

I do think NP schools need increased reform and regulation, but most RNs know far more than you think they do and by extension same with NPs. For example, most RNs have the knowledge to know that a patient has a UTI, they just don’t have the legal autonomy to make a diagnosis. That said, personally, I don’t think I should have to pay $400 a visit to see a MD to get a urine culture.

Regulate NP programs, regulate the scope of practice, but give NPs autonomy to practice independently.