How a Nurse Practitioner Should Negotiate a Contract
How should a nurse practitioner negotiate their NP employment contract? There are many ways to go about this. But I like to start with how much leverage you have, and when I say leverage, I mean, are you just out of school and have no experience? So, you’re going to need a lot of training and support, then you’re going to have less leverage. Are you experienced in this specialty? Have you worked there for many years? You’re not going to need much training. You can kind of hit the ground running and then you’re going to have more leverage. Also, you want to consider it depends on which state you’re in. As you know, as nurse practitioners, your scope of practice kind of depends on which state you’re in.
If you’re in Arizona, you have a lot of autonomy and you need less supervision and oversight. In more states, it’s more likely that you would need a supervising physician, depending on what kind of services you’re going to be providing. You also want to think about how much experience you have, how much training is going to be required, and how much supervision is needed in your state. That kind of gives you where you are on the leverage scale. Normally, you’re provided with an agreement. So, they’re going to hand you either an offer letter, or a letter of intent, or they’ll just start with the employment agreement and it’s going to have their terms listed on there. Now, these are negotiable, it’s customary in your industry, when you receive a contract that there’s a little bit of back and forth.
Then you’re going to look at the document itself and you’re going to see what’s important to you. And what do you want to kind of use your leverage to negotiate. Most people start with your base compensation because when you start a new job, what you’re really thinking about is the money. And I totally get that. It’s exciting. It’s attractive when you see that number on there and you want to ask for more, but I start with the non-compete clause. First, are you in a state where a non-compete clause is enforceable? If you are, I would read that very carefully and that’s the first thing I would negotiate. And the reason why I say that is because if you have an overly restrictive non-compete and your employment ends with this employer, do you have to move out of state? I mean, are there options for you? Do you know if you’re going to be in violation of this non-compete or not? That’s what I would first negotiate. Non-competes are normally for either one to three years.
I would try to negotiate it down to at least a year, if not six months. And then the area. You want to consider if this job ends, are you going to stay in the area? And if the answer to that is yes, I would negotiate that restricted area down, the mileage down. And then also, if there are multiple locations, you should try to negotiate it to only attach to your primary location. Non-compete clauses, in my opinion, are the first thing that I would try to negotiate. And then I would kind of go from there. Then you can kind of decide on your salary if you want to negotiate more. A lot of people have different strategies. They never say yes to the first number. If you feel uncomfortable with it, you can reach out to the employer and ask if they’re open to negotiating that amount.
You can kind of do your research. You can speak with a contract review attorney such as myself. We’re very familiar with the industry. So, we kind of know the ranges for your salary. But when you’re negotiating your compensation, you do want to consider not just that base number but any type of bonuses, signing bonuses, relocation bonuses, any type of quality assurance or production, and patient encounters. I mean, they really vary. The scale is huge on the extra compensation you can get. You not only want to think about your base salary, but you want to think about it in relation to all those other bonuses that you could potentially be receiving. So, we’ve gone over the non-compete. I feel like that’s the most important when you’re negotiating and then your salary or compensation. Then I would probably go to sort of other benefits.
I would try to negotiate that they’re going to be giving you some type of CME, continuing medical education allowance. Typically, that’s anywhere for nurse practitioners from like 2000 to 4,000. You want to negotiate this amount because this is something you must do annually to keep your license valid. So, your employer should be giving you some type of allowance for this. And then also, I would negotiate any type of licensing fees, dues for professional organizations, and for sure your DEA license if you’re able to have one in your state because DEA licenses are expensive, and that price just keeps going up. Those sort of ancillary benefits or business expenses is something that you also want to kind of keep on your radar. Don’t just negotiate your salary, you must think bigger than that.
Another thing, you can look at your without cause termination. That means, you can give notice and then terminate your employment. You normally have to give notice anywhere from 60 to 90 days, that’s standard. However, I have seen in some rural areas or high-need areas, that the notice period is anywhere from 120 to 180 days. That means you give notice, you want out, but you have to stay there for 120 days. So, that’s another thing I would negotiate down to at the very least 90 days because that gives everybody plenty of time to fill your position, especially if there’s some bad blood there, you don’t want to be forced to hang around in a place that you don’t feel comfortable with for such a long time.
There are lots of things you can negotiate in an employment contract. Sometimes the employer will tell you that this is standard for all physicians. But I don’t think it hurts to still ask for what you think you deserve. Especially non-competes, don’t forget about your non-competes, your compensation, and don’t just think about that base salary, you have to think about your bonuses as well. And then business expense reimbursement, and then just sort of benefits, but normally, benefits are non-negotiable because they are standard. It’s just, these are the benefits, health insurance, disability, and life insurance. And that is normally standard that I would say is probably not negotiable, but everything else you want to take into consideration together.
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