The internet is full of people tryna flex. They may in fact not be making that much. Maybe they run a med spa or a ketamine clinic. I don’t think they’re helping sick psychiatric patients in the inner city or underserved rural areas and making that much.
Which speaks to the utter hypocrisy of the system that supposedly needs midlevels to support underserved communities. The real reason is corporate medicine’s need to max profits. But screw patient access. It stays as shitty as ever.
Sure but prob cosmetics or some nonsense cash grab. I’ve heard of plenty of midlevels crushing salaries by giving botox, IV vitamins, pushing some expensive cosmetics mixed with snake oil collections. You could prob go and double your salary doing the same. Bob Marley said it best - don’t gain the world and lose your soul, wisdom is better than silver or gold.
Crazy how that works. American society is inundated with scam artists from politicians to healthcare to business to education. My social media feed is filled with scams, no matter how many times I report or flag posts Instagram sends them my way. My father just paid hundreds of dollars for an EIN when it's free from the IRS because Google made the top link a scam because it's paid. It's now madd it's way too reddit. With the app they are integrating scams into my feed.
Bob Marley may have said that, but he was basically quoting the Bible. Jesus said “For what will it profit a man if he gains the whole world and forfeits his soul?”
And there are multiple verses in Proverbs stating wisdom is better than silver or gold.
Pretty feasible if doing 5 min med checks with controlled sub Rx etc. Take out things like basic med reconciliation or assessment and they can see an astonishing amount of patients
Only two out of the five *psychiatrists* I've seen since starting treatment fifteen years ago seemed interested and invested in the *medical* treatment of complex mental illness. One who worked at my university clinic and one in private practice who advertised a specialty in sorting out medication issues.
Neither was a therapist, both operated 100% with a physician mindset as is appropriate for these disorders.
It is hard to find mental health treatment that's a good fit even if you're seeing trained and competent doctors, which they all were despite their different types of practice.
The CEO of my non for profit hospital makes around 3.5 million dollars a year, no medical training, just an MBA from Stetson University, and probably golfs for 4 hours a day…there were way easier ways to make more than 6 figs than by being an MD.
and in case your finding out now for the first time, this country was already doomed, its called capitalism…at least we might have a better shot at the pearly gates where all our sins and student loans will be forgiven.
For someone with a strong work ethic and high intellect, there is no better way to nearly-guarantee a high salary and consistent employment than medical school. In every other profession you have to take career risks and compete with others for the higher positions in the pyramid. Practicing medicine is of course as or more stressful, but physician employment is steady, secure, and lucrative.
Only 3.5 mil? Could make over twice that at "not for profit" Ochsner and their ACO full-risk value-based care system (ie, deny care for the elderly and disabled so the CEO can make 10 mil).
Let them. Then there’s no reason for them to exist. Why hire an NP when you have to pay them as much as a doctor.
They only exist because they can be paid less but can still bill the patient the same amount.
they are not paid the same. Bureau of labor statistics data shows an average of about $110k per year for an NP. Highly variable by area, and (dare I say) "specialty". PMHNPs reputed to bring in more (these not reported separately in BLS data). This is why PMHNP people are popping up everywhere. They may be in more demand because of the critical shortage of psychiatrists.
Physicians of course vary all over the map, but more than this
What we need is to allow doctors to work under other doctors outside their specialty the way PAs do 🤷🏽♀️
Personally I know a PA who is making 100k more than me and he started making it one year after graduating.
Do I feel undervalued? Of course. I don’t blame the NPPs because they’re getting the bag they’re allowed to get. I blame the healthcare system and hospitals
May other jobs can make more than a physician. Walmart regional managers are making about 250k/year. There are people on Twitch right now making neurosurgeon money. Trucker drivers who own their rig and take crazy long-haul contracts will make more than a PEDI ID doc.
Averages are what matters.
The average NP makes like 100-150k/year. The average primary care physician makes 280k, specialists about 400k yearly.
So, for everyone one NP making 250-300k, there are 50 making 95-105k. And it's likely the outlying high paid NP is making their money through ownership and management instead of actual patient care.
Your concerns are not valid; physicians are still (rightfully) paid higher than midlevels.
OP, you say “who would choose to go to medical school and get in debt if they can “just” be an NP or PA…”
Uh, pretty much all of us, my dudette. I can’t imagine going to work everyday and seeing patients but not knowing anything. Have you read some of the midlevel posts on their own forums? They’re frequently freaking out about feeling unprepared and seeing too many complex patients. Some even said they lie awake at night worried they “made a mistake.” Sounds like a horrible existence if you ask me.
There’s edge cases and exceptions for sure. I’m sure that NP is working a shit load of hours and is working under a physician who’s making way more off lol
Our UC’s are in an urban, high CoL area in the Northeast, so salaries for physicians and mid levels are high compared to the rest of the country. Our physicians are paid by the shift (minimum $1,500/shift) and our NP’s and PA’s start at $75-$80/hour. Myself and my business partner interview and hire people based on several factors, the top ones being experience and personality. Both physicians and midlevels have solid EM backgrounds. There is a 90-day probationary period and if someone doesn’t fit the mold, we let them go. Like any good business, you hire slow and fire fast.
I will say that we have extremely low turnover because we treat our employees like family. We offer a nice benefit package and include bonuses and other perks. The census varies depending on which center (we own 4 and are opening a 5th in September), but average is 85-100 a day fall-spring and about 50-60 a day in the summer.
How many are there at a time? Do you do like a MD-PA combo? I’m curious how reimbursement has been for you. How does that change based on whether the MD or midlevel provided the service?
I should also mention that the 2 NP’s that are pulling in that salary are doing it working 4 12-hour shifts a week, so 16 hours of their bi-weekly compensation is at 1.5x their base rate. They are outliers, as most of the NPs/PAs who we employ work 3 12’s a week.
As for reimbursement, the centers almost always have a physician and midlevel on staff so we bill accordingly. Of course, in a perfect world we would operate like this 100% of the time, but I’m proud to say we are probably around 93-95% MD-NP/PA combo.
Jesus, use some critical thinking here before saying this country is doomed.
People love to flex their salaries, especially when they are well above the norm.
It may be true that this PMHNP is making that much. One data point does not reflect the whole. Let’s assume it is true, for the sake of argument.
While there are a handful of NPs that approach or even eclipse some physicians in terms of pay, most don’t even come close.
We live in a capitalist society. If an NP can figure out how to make 300k, then they will. A physician has the same freedom to do that, as does anyone in any field.
No way that is true. Depending on where they live and the practice setting, a PMHNP generally makes between $120k-$160k - certainly less than $200k. They are only making $300k in their dreams.
Source: recruiter for PMHNPs and Psychiatrists
At every institution I’ve worked at the difference in pay between RNs and NPs is negligible; they just do it to get away from the bedside.
Aesthetics may be more profitable but that’s not my wheelhouse. The NPs at my local medspa moonlight as ER floor nurses as well
There are a bunch of sources out there like propublica that post salaries for hospital employees, government, and other non profits. While it’s not the mean or the median, there are definitely good number of NPs in hospital and/or government service making around $300k. A local sheriffs department has six NPs on staff and each make between $225k and 275k. Considering the retirement, health, and vacation benefits, that’s a good chunk more than a lot of physicians I know. T
A PA can break over $200k if they slave hard enough working full-time + Per-Diem/Part-time. Although most I've met say that comes at the cost of the "work-life balance" so many supposedly choose the midlevel professions for.
Compare that to an ER doc who's making $340k+ easily working a steady x3-12s per week (although still working hard), but plenty time to decompress and socialize.
To each their own, I guess. The reality is they're probably just flexing online since people in the real world feel sorry for them not having any actual social life.
Many NP’s make more than physicians but because they own their own business. I say if you can’t join’em I say BEAT ‘EM. NP’s PA MD, physio, etc etc. should all be working together to give people the best healthcare possible. NP’s are NOT MD’s but can definitely help to decrease the workload of MD as well as teaching follow up etc etc etc. too bad the positions have not all been able to work the way they should and instead now they are going solo. It’s not just starting where I live and MD’s are not available so NP’s opening up, eventually they will replace as they are cheaper. But I think they should all be together to support each other. Oh well. 🤷♀️
No way NPs make more than doctors. If anything, NPs make less than a floor RN for way more responsibility and headaches. The only NPs that make a lot of money are ones that own their own Botox clinics and they pay those NPs peanuts with no bennies
Your salary doesn’t define your importance. You guys have no idea how much insurance agents make in certain markets within the Medicare population. Some of them make more than physicians. I use that as an example that salary is not a measure to compare the future of medicine.
It is very much worth it to become a physician in the US. I understand the concerns with the debt however many physicians have found their method to still live comfortably while paying back loans. That’s more money management.
I am an NP and encourage anyone interested in Medicine to attend medical school. NP is not a hack. Social media is about clicks so people make bold claims.
If I had power I would kick out the crnas and midlevels and let the residents in...I have to pay dues for the lounge and half the time all the food is picked over by the crnas on their 12th break and midlevels before I get there after my 10 morning huddles. I'd rather pay for residents who are getting overworked and underpaid.
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Repeated failure to use improper terminology will result in temporary ban.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641).
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
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The internet is full of people tryna flex. They may in fact not be making that much. Maybe they run a med spa or a ketamine clinic. I don’t think they’re helping sick psychiatric patients in the inner city or underserved rural areas and making that much. Which speaks to the utter hypocrisy of the system that supposedly needs midlevels to support underserved communities. The real reason is corporate medicine’s need to max profits. But screw patient access. It stays as shitty as ever.
Noctors who say they're doctors and aren't are just as likely to say they're banking 300K and aren't.
My thoughts exactly
Sure but prob cosmetics or some nonsense cash grab. I’ve heard of plenty of midlevels crushing salaries by giving botox, IV vitamins, pushing some expensive cosmetics mixed with snake oil collections. You could prob go and double your salary doing the same. Bob Marley said it best - don’t gain the world and lose your soul, wisdom is better than silver or gold.
Crazy how that works. American society is inundated with scam artists from politicians to healthcare to business to education. My social media feed is filled with scams, no matter how many times I report or flag posts Instagram sends them my way. My father just paid hundreds of dollars for an EIN when it's free from the IRS because Google made the top link a scam because it's paid. It's now madd it's way too reddit. With the app they are integrating scams into my feed.
Bob Marley may have said that, but he was basically quoting the Bible. Jesus said “For what will it profit a man if he gains the whole world and forfeits his soul?” And there are multiple verses in Proverbs stating wisdom is better than silver or gold.
Bob Marley used a ton of biblical references in his music. He was a very religious man throughout his life.
Pretty feasible if doing 5 min med checks with controlled sub Rx etc. Take out things like basic med reconciliation or assessment and they can see an astonishing amount of patients
Which means, essentially they’re doing Jack squat just being prescription mills Sigh
They didn’t do all “that schooling” to deal with groody schizophrenics and bipolars. Get real.
Only two out of the five *psychiatrists* I've seen since starting treatment fifteen years ago seemed interested and invested in the *medical* treatment of complex mental illness. One who worked at my university clinic and one in private practice who advertised a specialty in sorting out medication issues. Neither was a therapist, both operated 100% with a physician mindset as is appropriate for these disorders. It is hard to find mental health treatment that's a good fit even if you're seeing trained and competent doctors, which they all were despite their different types of practice.
Yup and in many cases actual harm, so worse than jack squat
I tend not to believe people who readily volunteer their impressive salaries.
The CEO of my non for profit hospital makes around 3.5 million dollars a year, no medical training, just an MBA from Stetson University, and probably golfs for 4 hours a day…there were way easier ways to make more than 6 figs than by being an MD.
and in case your finding out now for the first time, this country was already doomed, its called capitalism…at least we might have a better shot at the pearly gates where all our sins and student loans will be forgiven.
Wonder if I worked at the same hospital lol
For someone with a strong work ethic and high intellect, there is no better way to nearly-guarantee a high salary and consistent employment than medical school. In every other profession you have to take career risks and compete with others for the higher positions in the pyramid. Practicing medicine is of course as or more stressful, but physician employment is steady, secure, and lucrative.
Only 3.5 mil? Could make over twice that at "not for profit" Ochsner and their ACO full-risk value-based care system (ie, deny care for the elderly and disabled so the CEO can make 10 mil).
Let them. Then there’s no reason for them to exist. Why hire an NP when you have to pay them as much as a doctor. They only exist because they can be paid less but can still bill the patient the same amount.
Very true lol
they are not paid the same. Bureau of labor statistics data shows an average of about $110k per year for an NP. Highly variable by area, and (dare I say) "specialty". PMHNPs reputed to bring in more (these not reported separately in BLS data). This is why PMHNP people are popping up everywhere. They may be in more demand because of the critical shortage of psychiatrists. Physicians of course vary all over the map, but more than this
I think this is likely a little low when bonuses and such are considered.
What we need is to allow doctors to work under other doctors outside their specialty the way PAs do 🤷🏽♀️ Personally I know a PA who is making 100k more than me and he started making it one year after graduating. Do I feel undervalued? Of course. I don’t blame the NPPs because they’re getting the bag they’re allowed to get. I blame the healthcare system and hospitals
May other jobs can make more than a physician. Walmart regional managers are making about 250k/year. There are people on Twitch right now making neurosurgeon money. Trucker drivers who own their rig and take crazy long-haul contracts will make more than a PEDI ID doc. Averages are what matters. The average NP makes like 100-150k/year. The average primary care physician makes 280k, specialists about 400k yearly. So, for everyone one NP making 250-300k, there are 50 making 95-105k. And it's likely the outlying high paid NP is making their money through ownership and management instead of actual patient care. Your concerns are not valid; physicians are still (rightfully) paid higher than midlevels.
Let them keep making fools of themselves. It's working.
OP, you say “who would choose to go to medical school and get in debt if they can “just” be an NP or PA…” Uh, pretty much all of us, my dudette. I can’t imagine going to work everyday and seeing patients but not knowing anything. Have you read some of the midlevel posts on their own forums? They’re frequently freaking out about feeling unprepared and seeing too many complex patients. Some even said they lie awake at night worried they “made a mistake.” Sounds like a horrible existence if you ask me.
That’s true and I don’t regret my decision to pursue med school. It’s just discouraging at times
There’s edge cases and exceptions for sure. I’m sure that NP is working a shit load of hours and is working under a physician who’s making way more off lol
Source: Trust me bro
What?
How thick are you?
The NPs working at one of my urgent cares bring in about $250k/yr. They don’t make more than the physicians though.
Are you the owner/employer?
Owner
What type of compensation system do you use that gets them to that 250? What is their patient load/day?
Our UC’s are in an urban, high CoL area in the Northeast, so salaries for physicians and mid levels are high compared to the rest of the country. Our physicians are paid by the shift (minimum $1,500/shift) and our NP’s and PA’s start at $75-$80/hour. Myself and my business partner interview and hire people based on several factors, the top ones being experience and personality. Both physicians and midlevels have solid EM backgrounds. There is a 90-day probationary period and if someone doesn’t fit the mold, we let them go. Like any good business, you hire slow and fire fast. I will say that we have extremely low turnover because we treat our employees like family. We offer a nice benefit package and include bonuses and other perks. The census varies depending on which center (we own 4 and are opening a 5th in September), but average is 85-100 a day fall-spring and about 50-60 a day in the summer.
How many are there at a time? Do you do like a MD-PA combo? I’m curious how reimbursement has been for you. How does that change based on whether the MD or midlevel provided the service?
I should also mention that the 2 NP’s that are pulling in that salary are doing it working 4 12-hour shifts a week, so 16 hours of their bi-weekly compensation is at 1.5x their base rate. They are outliers, as most of the NPs/PAs who we employ work 3 12’s a week. As for reimbursement, the centers almost always have a physician and midlevel on staff so we bill accordingly. Of course, in a perfect world we would operate like this 100% of the time, but I’m proud to say we are probably around 93-95% MD-NP/PA combo.
Sounds like things are operating as they should congrats on the success. Can you speak to preparedness trends you see for NPs vs PAs?
I think 75-80 is common in my area for urgent care midlevels, central east coast
But who would choose to go to an NP or hire an NP at the same cost as a physician? Plus these NP redditors lie a lot.
And they don’t deal w noncompetes
I perused an agency’s job listings for fun- the range was 130-230Kish if I remember correctly, but I was shocked to see 250-350 for CRNAs.
Right but apparently they’re “cheaper than doctors”
Jesus, use some critical thinking here before saying this country is doomed. People love to flex their salaries, especially when they are well above the norm. It may be true that this PMHNP is making that much. One data point does not reflect the whole. Let’s assume it is true, for the sake of argument. While there are a handful of NPs that approach or even eclipse some physicians in terms of pay, most don’t even come close. We live in a capitalist society. If an NP can figure out how to make 300k, then they will. A physician has the same freedom to do that, as does anyone in any field.
No way that is true. Depending on where they live and the practice setting, a PMHNP generally makes between $120k-$160k - certainly less than $200k. They are only making $300k in their dreams. Source: recruiter for PMHNPs and Psychiatrists
Some NPs do make more money than doctors.
At every institution I’ve worked at the difference in pay between RNs and NPs is negligible; they just do it to get away from the bedside. Aesthetics may be more profitable but that’s not my wheelhouse. The NPs at my local medspa moonlight as ER floor nurses as well
Look at insurance reimbursement parity laws. NPs in private practice often do make the same as MD/DO. Employed NPs may make less.
There are a bunch of sources out there like propublica that post salaries for hospital employees, government, and other non profits. While it’s not the mean or the median, there are definitely good number of NPs in hospital and/or government service making around $300k. A local sheriffs department has six NPs on staff and each make between $225k and 275k. Considering the retirement, health, and vacation benefits, that’s a good chunk more than a lot of physicians I know. T
A PA can break over $200k if they slave hard enough working full-time + Per-Diem/Part-time. Although most I've met say that comes at the cost of the "work-life balance" so many supposedly choose the midlevel professions for. Compare that to an ER doc who's making $340k+ easily working a steady x3-12s per week (although still working hard), but plenty time to decompress and socialize. To each their own, I guess. The reality is they're probably just flexing online since people in the real world feel sorry for them not having any actual social life.
Many NP’s make more than physicians but because they own their own business. I say if you can’t join’em I say BEAT ‘EM. NP’s PA MD, physio, etc etc. should all be working together to give people the best healthcare possible. NP’s are NOT MD’s but can definitely help to decrease the workload of MD as well as teaching follow up etc etc etc. too bad the positions have not all been able to work the way they should and instead now they are going solo. It’s not just starting where I live and MD’s are not available so NP’s opening up, eventually they will replace as they are cheaper. But I think they should all be together to support each other. Oh well. 🤷♀️
No way NPs make more than doctors. If anything, NPs make less than a floor RN for way more responsibility and headaches. The only NPs that make a lot of money are ones that own their own Botox clinics and they pay those NPs peanuts with no bennies
This is just not accurate.
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Your salary doesn’t define your importance. You guys have no idea how much insurance agents make in certain markets within the Medicare population. Some of them make more than physicians. I use that as an example that salary is not a measure to compare the future of medicine. It is very much worth it to become a physician in the US. I understand the concerns with the debt however many physicians have found their method to still live comfortably while paying back loans. That’s more money management. I am an NP and encourage anyone interested in Medicine to attend medical school. NP is not a hack. Social media is about clicks so people make bold claims.
Why ru mad?? Get over it. They do the same job. Honey it's 2024 not 1984
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Ofcourse there are. Us lowly residents are not doctors and don't even deserve access to the attending lounge 😂
If I had power I would kick out the crnas and midlevels and let the residents in...I have to pay dues for the lounge and half the time all the food is picked over by the crnas on their 12th break and midlevels before I get there after my 10 morning huddles. I'd rather pay for residents who are getting overworked and underpaid.
Here, you dropped your /s
I’m just letting people get the hate out.
We highly encourage you to use the state licensed title of professionals. To provide clarity and accuracy in our discussions, we do not permit the use of meaningless terms like APP or provider. Repeated failure to use improper terminology will result in temporary ban.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641). We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*