Hiring a PNP


The PNP Advantage: Guidelines for Hiring a PNP

Why Hire a PNP?

You want to expand care, increase patient satisfaction and control costs. It sounds like mission impossible-but there is a solution: make Pediatric Nurse Practitioners (PNPs) part of your care team.

PNPs practice in a variety of settings: ambulatory, HMOs, private practices, specialty clinics, hospitals, emergency rooms, schools, home care, rural and underserved areas.

The following example of two private practice models illustrate the benefits of adding PNPs to the clinician team. They are equally compelling in most care settings. For our models, we'll assume the Pediatricians have an annual salary of $120,000, while the Pediatric Nurse Practitioners have an annual salary of $60,000. See the discussion of typical salaries below.

Practice X: Four Pediatricians, each seeing 25 patients per day. Total patients per day: 100. Total salaries: $480,000.

Practice Y: Two Pediatricians and four Pediatric Nurse Practitioners, each seeing 20 patients per day. Total patients per day: 120. Total salaries: $480,000.

  • Which practice will have the highest patient satisfaction and most extensive hours?
  • Which practice will have the lowest per-patient provider cost?
  • Which practice will have the better cash flow and strongest bottom line?
  • Which practice will allow the Pediatricians to see the most interesting cases, and yet be less time-stressed?

You know our answer-but why not ask one of the many Pediatricians who have taken their practices to the next level by collaborating with PNPs? For example:

"Having Pediatric Nurse Practitioners is a win-win-win situation: our patients love them, they provide outstanding care and they are cost effective for our practice." -Doug Olk, MD, Department of Pediatrics, Medical Associates Clinic, Dubuque, IA.

The bottom line

According to an article in the March 20, 2000 issue of Medical Economics Magazine, hiring Nurse Practitioners often benefits physicians. Patient satisfaction increases due to extended visits and same-day appointments. And physicians are less harried when NPs help eliminate patient backlog.

The magazine reports the Medical Group Management Association claims a Nurse Practitioner can provide $30,000 in annual profits to a practice. They go on to say that NPs increase the size of patient panels, producing larger capitation payments in managed care markets, and allow doctors to concentrate on better-paying cases with fee-for-service plans.

Adding $30,000 per NP annually to the bottom line can enhance both physicians' and NPs' income, while still providing investment income to grow the organization.

PNPs are qualified to perform complete physical exams, take health histories, diagnose and treat common acute minor illnesses or injuries, order and interpret lab results and x-rays, manage stable chronic illness, counsel clients and provide health education. Many may prescribe medications according to state law.

PNPs are a cost-effective asset for your organization or practice. NAPNAP's annual survey of PNPs indicated the largest group had salaries in the $50,000 to $70,000 range, though individual salaries may vary depending on location and experience. PNPs usually rank the opportunity to practice to the fullest extent of their education and licensure, and the chance to make a real difference in children's lives, as important job benefits.

Need more reasons to hire a PNP?

Since 1965, PNPs have provided comprehensive care to children and families by focusing on health maintenance and education, illness prevention and minor and chronic illness management.

PNPs are capable of providing 60-80% of primary and preventive health care in a cost-effective manner. They are in demand due to consumer recognition, acceptance and satisfaction.

PNPs are knowledgeable about and work closely with community agencies.

PNPs are pediatric (registered) nurses with advanced education (usually a master's degree) in pediatric nursing. They meet state licensing, competency standards and continuing education requirements.

Most PNPs are certified by a national certifying agency, guaranteeing expertise and competency maintenance.

PNPs are eligible for third party reimbursement under Medicaid, in some areas Medicare and in some states, private insurers.

Many additional services available from PNPs can greatly increase patient satisfaction with your practice or organization. They include:

  • Prenatal consultations
  • Post partum/newborn hospital visits
  • Breast feeding consultation and follow up
  • Premature/high risk infants follow up
  • Nutritional/Feeding counseling/guidance and follow up
  • Comprehensive adolescent health care services
  • Sports Physicals
  • Management of families with special health care needs
  • Chronic Illness management
  • Parent/Adolescent educational programs
  • Consultation regarding complex medication regimens
  • School visits regarding Individual Family Service/Education Plans
  • Staff development/continuing education

How to find a PNP

Planning on hiring a PNP, but don't know where to start? Here are some ideas:

Contact the National Office of the National Association of Pediatric NurseĀ  Practitioners (NAPNAP) at 856/857-9700 to advertise your job opening through:

  • The NAPNAP Career Connection
  • The Pediatric Nurse Practitioner newsletter, local chapter newsletters, and on the NAPNAP website. Call 856/857-9700.
  • The Journal of Pediatric Health Care. Call 800/453-4351.
  • Annual NAPNAP Conference exhibitor's booth. Call 856/256-2300.
  • Local newspapers and classified want ads.

Contact universities or colleges with PNP programs. A list of schools with PNP programs is available through the NAPNAP National Office.

Contracting considerations when hiring a PNP

As with any employee, building long-term relationships with your Pediatric Nurse Practitioner through high job satisfaction will be most beneficial and cost-effective for your organization. A formal contract will make both parties fully aware of what is expected. In negotiating the employment of a PNP, the following should be considered:

  • Orientation period, expectations, plan for mentoring to the new position
  • Salary, including a plan for increases
  • Expected hours of direct services, office time, community time, overtime policy
  • Hospital privileges, rounding schedule and responsibilities
  • On-call expectations and reimbursement
  • Prescriptive authority
  • Support staff such as nursing, clerical, billing
  • Malpractice insurance
  • Health, dental, life insurance
  • Long-term disability insurance
  • Pension benefits and vesting period
  • Educational leave and reimbursement of costs
  • Reimbursement for professional fees such as licenses, professional organization dues, certification fees, etc.
  • Sick leave, short- and long-term illness coverage
  • Maternity, paternity, adoption leave
  • Personal leave time for family needs, family illness/death, child related issues, legal transactions, relocation, etc.
  • Military and jury duty leave
  • Vacation time; how much, how it is accrued, and carry-over time
  • Paid holidays
  • 401K savings plan, employer contributions
  • Relocation benefits
  • Performance review process, frequency, criteria, mechanism, merit and cost-of-living increases
  • Severance package

NAPNAP recommends that the above criteria be included in a formal employment contract that both parties should have reviewed by an attorney prior to signing. The contract should be reviewed on an annual basis.

NAPNAP, the professional association for PNPs, is available to answer questions regarding the PNP role, locating a PNP for employment and developing the employment contract.