How Much Money Do You Deserve To Make on NPBusiness.ORG

How Much Money Do You Deserve To Make?

Who am I to ask? Good point!

But this is not about me…

This is about you asking yourself some tough questions, like:

  • How much money do I want to make?
  • How much money do I deserve to make?
  • How much money am I comfortable with?
  • And what amount of money would be too much for me?

While it sounds strange to suggest there is such a thing as too much money, there is!

You see, most of us have an internal compass, tucked away, guiding us from below the surface. It determines our level of comfort with money throughout our lives.

The Thermostat

In “Secrets of the Millionaire Mind: Mastering the Inner Game of Wealth,” T. Harv Eker refers to it as “the thermostat.” Your internal thermostat defines your money blueprint, your relationship with money.

And just like a thermostat will provide temperatures within a set range, your money thermostat will deliver financial results within a set range.

When your thermostat is set too low, chances are it’s challenging to attract the level of money in your life that you want. Additionally, you may have a hard time keeping it.

On the flip side, when your thermostat is set much higher, you may find it almost effortless to both attract and keep more than enough money in your life.

Lottery Winners

To show us proof and examples, Eker shines the light on lottery winners.

Research shows that regardless of how much they win, most lottery winners lose the majority of their winnings within a short amount of time.

It seems the newly found wealth creates too much friction and discomfort in their lives. That’s why, eventually, in some way or another, most give it all back. And without their winnings, they’re back to their original, comfortable financial state.

I like his metaphor…

After all, we know what a thermostat is and how to change it, right? All there’s to do is walk across the room, hit a button or two, and change the setting.

So if you’re not happy with your financial situation, perhaps it’s time to crank up your thermostat.

But here’s the problem…

If only it were that easy. Unfortunately, it’s far more challenging to change your money thermostat; however, you can do it.

How?

Some Ideas

Here are a few suggestions to get you started…

  1. Discover your money story; we all have one.
    For some, their money story centers around lack and struggle, while for others, the story is one of abundance and opportunity.
    Some believe that money is the root of all evil, while others view money as the solution to all problems.
    We form our money story in childhood and hang on to it into adulthood, no matter if it still makes sense or not.
    What’s your money story? You must first know what your beliefs around money are before you can make changes.
  1. Listen to the words you use around money.
    Do you tell yourself you can’t afford it, or do you ask yourself how you can afford it? Just asking this simple question alone can make all the difference.
    Do you think in terms of expense and cost, instead of making an investment?
    How you talk to yourself about money speaks volumes about your beliefs. When you’re mindful of the words you use, you will discover your money story.
  1. Start a journal.
    Write down your financial goals and how close you are to achieving them.
    Write out your money story. Explain your thoughts on why you think it is your story. Do you remember events or experiences that affected how you feel about money?
    If you have beliefs about money that are holding you back, write them down. Ask yourself how your beliefs would need to change to move you closer toward your goals.
    Do you feel guilty about money?
    Do you feel there never is enough?
    Do you feel undeserving?
    Or perhaps you’ve been told you wouldn’t amount to much?

The first step in making positive changes is becoming aware of what you repeatedly tell yourself.

Once you uncover your money story, you then can create a new one. One you want to live by in the future.

Join the conversation by leaving a comment or question below.

 

By Johanna Hofmann, MBA, LAc; regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.

Comments 36

  1. Hmm… Well, money is an object used in exchange for a product or service that meets a need. The more needs I meet, the more money I earn. Somebody once said, “if you want more, be more”. Although there are limits to that, it’s basically true.

    It’s the LOVE of money that is evil, although plenty of people do evil things for money or in the name of making money. Money is the only thing the electric company accepts for my electric bill, and the only thing Sallie Mae will take for my school loans, so I need a certain amount of it in as short amount of time as possible so I can be less constrained by “needing” a certain amount every month.

    Here’s to a financially successful practice – meeting needs and paying my bills!

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  3. It has been my observation that there are two kinds of people: Those who regardless of how much money they have will never have enough, and those who regardless of how little money they have will always have extra…. to a significant point, it’s a choice. I have had (in my past) 8 years in a row significantly below the poverty line but was not impoverished during that period. Spending less than we bring in is a worthwhile start. Living below our means has been a worthwhile exercise regardless of annual income. Learning these lessons with no support from family or friends was at times difficult but rewarding.

  4. Good points all around. I like the money story and I can see how money story could help to clarify my perspective on how I feel about money.

    After reading the article, I find myself wondering if anyone asks a physician how much they deserve to make.

  5. Money is the byproduct of services rendered. “Services”, in modern medicine, is a loose term. All healthcare providers are not created equal. The same can be said for lawyers, mechanics, or baseball players.

    For me personally, I know what I’m worth (today). I also know what a company will get if we work together. In my career, many companies also knew what they’d get as well.

    I’m a former US Army medic who played college ball and has a degree in nutrition. To me, those are selling points to make me personable. Previous employers wanted to exploit that after the fact. I’m also a Doctor of Chiropractic and college professor. I had a job once where I found myself reading all of the films and doing every type of physical. They also placed every intern/resident of any kind, with me. It was cool at first until I became the only one with no pay to show for it. Lastly, I’m an HIV and hormone replacement specialist. And you guessed it, somehow, I ended up with those patients.

    With age and experience, I don’t get exploited like I once did. I also don’t five discounts either. Loving service is my first technique. Thus, my patients and my organization all know my track record. So I demand a lot. But I also give more than I receive. So I have no shame in saying it’s going to cost a company $105 an hour for me. The relationship is symbiotic. My family and I are able to live great lives due to hard work, sacrifice and commitment. My organization benefit from expertise and my patients benefit from from holistic care. Everyone wins.

  6. When forced to work under a Doctors authority such as in Michigan, one needs to ascertain what the average 99213 compensates across all payer formats. I have found $125 an average (insurance and client) when excluding Medicaid. So if one sees four clients in an hour, that is $500 in gross hourly revenue. In Michigan, NPs are lucky to see $50 / hour compensation and maybe $35 in benefits. Facility or building charges and malpractice insurance do not come close to eating up another $100 per hour, as that would be $200,000 per year, working about 2,000 hours. So at a minimum, a doctor is a pimp making $600,000 plus off of the work of every nurse practitioner ($500-$50-$35-$100) in restricted practice states. This is how I view doctors.

  7. Good point, and for the most part…probably not. I think most physicians go in with a higher expectation that nurses where the mindset is likely different. Even 10 years ago, it was not okay to have a money conversation among NPs.

  8. Regardless of restricted practice or now, on average, most commercial payers (including Medicare and some Medicaid states) pay NPs and PAs less than physicians. It’s not just a Michigan issue.

    As a practice owner, regardless of your state’s scope of practice, it’s important to be aware of your payer mix and how it impacts your bottom line. There are some payers we cannot afford to take because reimbursement is so low and it puts a strain if not a terminal blow to a practice.

  9. A lot of good responses to this topic. I feel that NP’s should be paid . according to our Master’s/DP/PHD, years experience, specialty/field of medicine, and financial income from RVU’s (or a percentage of the doctors billing). If there were a mathematical formula for the above numbers, I’m sure there is a way to determine that particular NP’s salary. I currently work 5 jobs, which is frustrating since I feel there should be 1-2 jobs that should be able to pay me sufficiently for the high cost of living in the New York/Long Island area. Each job allows me to see a wide variety of patient’s, and allow all these subspecialties to give my expertise to the physicians I work with. However, with 15 years experience, and a strong work ethic, I feel my value is not compensatory my full-time income. It also gets frustrating when I hear Janitor’s in local schools, and people who go to trade schools are making more that NP’s who have their Masters degree.
    There should be a more fair way to be compensated without feeling like we are being taken advantage of. In an Emergency Department I work at the NP’s/PA’s see 85% of the volume, yet the physicians are the ones making 400 plus a year. The full time NP’s/PA’s make only 100. Also that Outsourced group cover the Hospitalist/House service as well. We are responsible for covering the house, a detox service, and rehab floor. This is without additional pay, or incentives. To me that is administrative greed, and not appropriately paying for our time, services, and experience.

  10. I couldn’t agree more! I like the point you made. Instead of saying, “I can’t afford it. What do I need to do to make the money.”

  11. Jamie what does a chiropractor do to replace HIV and hormones? Seriously, that is very important to know.

  12. As Dave Ramsey often responds to his radio show callers query, How are you? “…better than I deserve”. I don’t ‘deserve’ much but will work hard for money to meet the needs of my business AND THEN SOME. I pursue extra income to create a surplus, from which I can share generously with others (disadvantaged patients, students in training, my community etc.) and live a creative, healthy life. I love my private practice. It is rather unconventional but when I die there will be no regrets.

  13. Value may be in the eye of the beholder, both the NP and their employer. We need to value ourselves first then know how to negotiate, both for patient time and the time spent in all the documentation/phone/insurance time that is needed to give good care. Also we need to be more open with each other about compensation issues so that one NP in the clinic/hospital is not getting payed must less than a colleague. Sometimes where you start in terms of compensation per hour is where you stay for years while new hirers can come in at a higher rate.

  14. I think is an important conversation to have with soon-to-graduate NP students across the board. Some practices will ask you what you want to start at and others will tell you what you start at. It’s important to know market-wise what your value is. As a PNP, I had a hard time (even using salary.com) finding the average annual salary for primary care PNP. During an interview, I was asked what I wanted to start at and that was probably the hardest question of the interview! I didn’t want to oversell myself but I also didn’t want to low-ball myself.

    As NPs, we need to value ourselves, our skill set, and our services and not low-ball. I think if we try to go “gently” on what we’re worth financially, our worth across the services will be see as low value. That doesn’t mean we go in asking for an unrealistically large salary. It means we ask for a realistic salary.

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  16. So, if you bill me out at 85% of the Physician rate I should get paid 85% of the Physician pay. Pretty simple. As for the other money issues. How much you make is irrelevant to your financial situation. ALL financial problems originate on the spending side of the ledger NOT the revenue side. Currently in the US 75% of people live pay check to paycheck. That means there are a ton of people making a fat six figure income that are not more financially stable than a person making $30k a year.

  17. Brilliant, CAM Mcb. There’s nothing better than hard, cold math. I.Love.It. My realization, however, over decades of practice, is NPs are heavily utilized in low income or Medicaid services. That clearly changes the reimbursement math. Medicare reimbursement does as well. Nonetheless, I am a strong supporter of Medicare for All. My concern is that future generations will be unable to afford health care, and/or be saddled in the same dead end jobs for the insurance benefits that WE have been chained to over our professional and family raising lifetimes. Employment for our kids is not the model we grew up with– no lifelong jobs, tenures or pensions. Clearly, my personal money thermostat is weighted less by money than by enough to get by, yet let our future generations flourish. And math again is involved. While the ten year estimate of national cost for Medicare is being touted at 32 trillion, well, guess how much private insurance is estimated to hit our national pockets? 35 trillion! Do the math, people. Thank you for a great article.

  18. Good points! I’m not sure where the idea of not sharing compensation initially came from…but it likely causes us to stay locked in. It’s also precisely what insurance companies have done, in our contracts, by not allowing us to share the different reimbursements we receive from them. I

  19. Over the years, I have found it best to not be the first person to put out a number. If it’s unavoidable, it’s best to go high and negotiate from there.

    Finding worth, especially for new grads can be difficult, and is something that SHOULD be taught while you are still a student. The other aspect of this, is, as a new grad/new employee…most employers lose money initially until one is up to speed. Hence, if starting at a lower amount, it’s important to build into the contract a salary renegotiation after 6-12 months.

  20. My employer presented me with a break down of my “total compensation” which included my PTO as a figure above and beyond base salary. So the “overall compensation” was about 25K more than my take home pay. I found this interesting, since by definition, I’ve always thought that it’s supposed to be, well, paid time off, not something in addition to my base salary (I thought it was included, since I am making the same amount with paid time off that I make on days when I am at work). In other words, the summary included base salary, benefits and PTO as an additional amount that (apparently) the company is sacrificing by giving me paid time off. Kind of like saying, this is what you’d make if you had no PTO. I had not ever seen this before. It does not soften the edge that I’ve felt, at the end of the day, I’m just not making what I’m worth in terms of take home pay. But the options are very limited where I am, and I do try to “look at the overall compensation” and other job perks when deciding whether to stay or go in the future.

  21. A few years ago while looking to transition from Locum back to a perm position a colleague suggested sorting out “my line” ( as opposed to a bottom line), and ask for that pay. Without negotiating.
    I have employed that tactic since (2 different employers). I have adjusted it for the cost of offered benefits, and have found it to be very liberating. While job searching I encounter a bulk of employers that immediate want to negotiate, and we part ways when I tell them I’m not willing to negotiate at all. But for those that are willing to move forward, it has been very satisfying and has led to 2 very fulfilling jobs on many different levels, including the one I am currently practicing at.

    To be paid what I believe I am worth, without having to compromise that amount in negotiations, has led to an increased job satisfaction for me. I know what I am worth, and if an employer is not willing to pay that then I am not the employee for them.

  22. This is fascinating conversation!!! I know what I’m worth to patients, and employers but it not near the same. Private cash patients , no insurance billing would be great. Here is my fee, it’s based on time spent and complexity of visit.

    I too was told that I needed to take my base salary (no compensated overtime) add in the cost of PTO, health insurance provided, oh and my on call pay and that shows I am in line with regional salaries. If I was working on call I would not expect to be paid. So if I work more I’m actually paid less. I miss the logic

  23. I have been a master’s level NP/CNM for 20 years. I just recently got a job that I think is paying what I’m worth. And I had to move to another state to get it. Well, it’s probably not what I’m worth with 20 years experience but it is a new field for me so I’m happy with the starting salary.

    As a nurse-midwife there were many many days where I was in the hospital for 48 hours or more, exhausted, stressed, and no end in sight. The nurses sitting next to me were making more than I was! I had the majority of the liability, all of the on-call hours, yet I was making less. A lot less.

    Figuring out what you are worth is all well and good but fighting the monster medical system in place can be fruitless.

    Sometimes you just have to pay the bills.

  24. Hi Terri,

    Great comments. It’s true that sometimes the monster is too much to tackle. But oftentimes we can do better by making a job move. Yes, bills need to be paid, but we also need (as a group), to take a stand.

    Thanks for stopping by.

  25. I am reimbursed by rvus and find this the most satisfying for me personally. I have a base salary that can be converted to the number of rvus needed per quarter. Anything over the quarterly requirement is paid as a bonus. Negotiating a conversion factor, the amount paid per rvu, is important. I find that NPs undervalue their work. $28-35 seems to be a range across the country. This is based on my observation and speaking with other NPs. I know NPs making $24 per rvu who do not know they should negotiate a higher conversion factor. Proper coding is required to be reimbursed properly in this system and find most NPs and physicians as well, undercode. I urge everyone to read CMS evaluation and management requirements. Study Medicare’s examples and you will all read with your mouth hanging open at the minimal requirement for a 99214. I make 60% of what my base is in bonuses. I feel I am properly reimbursed.

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