Tuesday, November 17, 2015

How much should a health care provider make?

Well, as I near completion of the program I started in August of 2013, I am on the cusp of looking for a job and metaphorically moving up the ladder a rung or two from where I currently reside as a bedside RN. There is still a final exam which must be completed, and also a licensing exam which is no small thing. But I am at least close. At present, the Nurse Practitioner salary seems to be in a general range of about 85k to 105k depending on the setting. Generally, it seems, those doing hospital work will probably be in the >100k range, while those who do clinic work are probably in a 85k-95k range unless they are working in a "treat em and street em" type of practice wherein they see north of 30 patients a day. Patients seem to hate this approach but the doctors who can turn em like that can make some good money.

These days, it seems that when we explore solutions to trying to make health care cheaper, we frequently come with solutions designed to make providers make less money. Admittedly, my ascension to the role of NP is one of those solutions. To some degree, I am a scab and the rise of others like me will put downward pressure on the wages of MD providers who choose a career as a general practitioner. I genuinely have mixed feelings about that. I'm not going to hurt the career of people like my preceptor who are truly at the tail end of their career, but for younger MD's who are still paying off that multi hundred thousand dollar tuition debt, I am indeed competition. So, just for discussion sake, I was curious about what people think a provider should make.

Here is one link http://mdsalaries.com/2011/08/23/emergency-medicine-physician-salary/#comment-2035 if you look down the righthand side, it has a list of salaries. Generally about 200k on up. Here is an NP site http://www.payscale.com/research/US/Job=Nurse_Practitioner_(NP)/Salary Surely there are outlier NP jobs that get up in that 150k range, but that is not the norm. When it comes to billing, NP's can bill at about 85% of what an MD makes, but unless they run their own practice, they are likely only going to make about 65-75% of what a physician makes. Then again, even though most specialists all go through a internal medicine residency before specializing, those who stay at the primary care level are probably also in a situation wherein they will only make 65-75% of what a specialist does.

So, question of the day, if an NP makes about 100k, the general MD makes about 210k and the specialist makes anywhere from 350k-500k, should we seek to make health care cheaper by just making all three listed here make less money or do those salaries seems fair?


  1. Those salaries seem fair to me, given overhead expenses, such as malpractice insurance. But that got me to thinking "what do Canadian doctors make, given that they are private contractors, working for their particular province. Given the current flack about the evil of single payer health care you would think they make much less than U.S doctors. Here us a link worth looking at:


    1. That was an interesting article and ironically, there was a link at the bottom to a story about using NP's to help face a physician shortage. Once you factor in the exchange rate too, that basic salary starts to fall more in line with US doctors.

  2. Like everything in life Max, you get what you pay for.

    Want the best and the brightest, you pay them well. Want a hack, by cutting salaries in half, you can flood the field with hacks.

    Personally, I pay more for the best physician I can find.

    As a side note, People hire me and pay me upwards of 200 an hour. They can hire others for half that amount. With me, I get the job done under budget, and more important, on time as time is money. They always get me when they give me a job, not an employee with less experience. Unlike others in the field I will occasionally do a job for expense only. Why? because I don't need the additional income. That is appreciated by the businesses I serve.

    Max if your good at what you do, charge a fair rate, you'll have more customers than you want. A good surgeon doesn't advertise, they have more business than they can handle with referrals. The same will apply to you if you are a top of the line healthcare professional you'll have no problem.

    Cutting the salary of healthcare professionals does nothing for the quality of care.

    1. And that Louman my friend is why you don't understand America. You don't need any more income. You only need to protect what you have.

      Personally, I pay more for the best physician I can find.

      How do you know he is the best. Because someone told you so?
      Because he is more expensive? Doesn't make him the best just the most expensive. Cost is based on demand. Maybe whomever told you he was the best told 100 other people the same thing. Now he can charge more because he is in demand. Really lou price doesn't always mean better.

    2. He meets my needs. Has a list of great specialists. When I call for an appointment first question, are you ok, is it a serious problem? If so I see him the same day if not I can wait a day or 2.
      He has great communication skills, spends what ever time needed to address my issues and makes sure I understand the treatment. iI there are options he explains the options and his recommendations.

      Best of all he doesn't accept ACA insurance or medicaid patients.

      As to my business, I enjoy the work and help the businesses when they need it.

      And what you will never understand, Supply and demand, superior service. I make why I make because I not only am in demand I do it better than most companies. Doctors are exactly the same.

      p,s, The doc is selective as to who he takes as a patient.

  3. I know where you can get a job! Did you know that Target Corporation has sold their pharmacy business to CVS? CVS is putting a NP run minute clinic in everyone of them. Might be a treat 'em and street 'em deal but it's a start.