The answers to the following questions will give an NP an idea of a prospective employers' expectations. NPs may be surprised that none of the questions ask about the employers' philosophy of patient care, who the NP would be working with, office hours, what procedures the employer expects the NP to perform, or whether the NP will work in office, hospital, nursing home or conduct home visits. Those issues are important, and most NPs know how to address those issues in a job interview. Note that none of the questions directly ask about salary, hourly rate or percentage of collections the employer would pay the NP. Instead, the questions probe for information which should help an NP determine whether a relatively higher or lower salary is in order, or whether to seek a percentage of billings or a percentage of collections. Compensation should be addressed in the second meeting, or late in the first meeting.

Ask these questions:

1. Why are you interested in hiring an NP?
2. Is there any aspect of your practice that you want relief from?
3. What aspect of your practice would you like an NP to develop?
4. What is your special interest?
5. Do you want to pay a salary an hourly rate or percentage of billings?
6. Will you pay for benefits or would you rather pay a higher rate but without benefits?
7. If paying for benefits, what would you cover?
8. Do you want me to purchase my own malpractice policy or do you want to cover me under your policy?
9. If you cover me under your malpractice policy, is your policy a claims made or occurrence policy?
10. If your policy is claims made, how much is the premium for a "tail"?
11. Would you pay the premium for the tail?
12. If I purchase my own malpractice policy, would you pay me a higher salary or hourly rate?
13. If, rather than a salary, you would like to pay me a percentage of billings or collections, what is your practice's collections rate?
14. If you want to pay me a salary, how many patient visits or RVUs per day do you expect me to handle?
15. Would you expect me to take call? If so, how often?
16. How would you compensate me for taking call?
17. Would you expect me to sign a restrictive covenant or non-compete clause? If so, how would you propose to compensate me for agreeing to limit my future opportunities?
18. Do you have an overflow of patients?
19. Do you want me to develop my own panel of patients or do you want all patients to think of you as their primary clinician and me as your assistant?
20. If you want me to develop my own panel of patients, would you:
    • Put my name, along with yours
          on the office sign
          in provider directories
          on any advertisements for the practice
    • Back me up if I have trouble enrolling with insurer/payers
    • Bill for my services under my name
    • Provide me with monthly statements of billings, collections, accounts receivable
    • Let me participate in negotiating fee schedules and resolving problems with claims?

Most of these questions should not provoke anxiety in either the nurse practitioner or the employer. However, questions 11, 13, 16, 17 and 20 may provoke a prickly response. You may want to re-word the questions to suit your own style.

For most questions, there are no right or wrong answers. The objective is to address controversial issues up front rather than be surprised after taking a job. Here are some answers NPs may hear, with comment:

1.	Why are you interested in hiring an NP?
	"Relief." "I need someone with interests or skills I don't have." "Profit." If an employer wants profit, ask how much profit the employer is looking to make from the NP, per year.
2.	Is there any aspect of your practice that you want relief from?
	"Thursday afternoon clinic" "Patient counseling" Almost any answer is acceptable, except "In one month, I'm leaving the country for a month."
3.	What aspect of your practice would you like an NP to develop?
	"Home visits" "Nursing home visits" "Well women care" Any answer acceptable to the NP is fine.
4.	What is your special interest?
	Any answer that suits the NP is fine.
5.	Do you want to pay a salary, an hourly rate or percentage of billings?
	New NPs will want a salary or hourly rate. Experienced NPs may want a percentage of billings.
6.	Will you pay for benefits or would you rather pay a higher salary but not provide benefits?
	Either answer is fine, depending on the NP's needs.
7.	If paying for benefits, what would you cover?
	Health insurance, paid holidays and vacation, paid time and tuition for continuing education are customary.
8.	Do you want me to purchase my own malpractice policy or do you want to cover me under your policy?
	If the employer wants to cover the NP under his/her own policy, be sure to get the following answers to questions 9 to 11 -- "occurrence," "not expensive" (get an amount), "yes."
9.	If you cover me under your policy, is your policy a claims made or occurrence policy?
	Most physician practices have claims made policies. However, occurrence policies are preferable.
10.	If your policy is claims made, how much is the premium for a "tail"?
	The usual answer is "Don't know." However, the NP needs to know, as these premiums are expensive.
11.	Would you pay the premium for the tail?
	If the answer is "no," the NP should purchase his/her own occurrence policy. If the answer is "yes," the NP needs to get the promise in writing, before taking the job.
12.	If I purchase my own malpractice policy, would you pay me a higher salary or hourly rate?
	If the answer is "no," it would not necessarily be a deal breaker.
13.	If, rather than a salary, you would like to pay me a percentage of billings or collections, what is your practice's collections rate?
	If the answer is 50%, ask for a percentage of billings rather than a percentage of collections. Or, ask for a salary or hourly rate. If the answer is 90%, it is safe to ask for a percentage of collections.
14.	If you want to pay me a salary, how many patient visits or RVUs per day do you expect me to handle?
	If the answer is more than 25 patients a day or more than 20 RVUs per day, consider asking for a percentage of billings rather than a salary. See Buppert, C., "Productivity Incentive Plans for Nurse Practitioners" for more on this issue.
15.	Would you expect me to take call? If so, how often?
	Answers vary tremendously. If frequent on-call services -- more than 48 hours per month -- are required, it is reasonable for an NP to expect compensation for taking call.
16.	How would you compensate me for taking call?
	NPs are getting $25 per 24 hours to $1000 per week, depending on call activity
17.	Would you expect me to sign a restrictive covenant or non-compete clause?
	The preferred answer is "no." If the answer is "yes," consider this issue a potential deal breaker.
18.	Do you have an overflow of patients?
	The preferred answer is "yes." If the answer is "no," the job may not be long lived.
19.	Do you want me to develop my own panel of patients or do you want all patients to think of you as their primary clinician, and me as your assistant?
	Either answer is fine, as long as NP and employer agree.
20.	If you want me to develop my own panel of patients, may I market myself?
	The preferred answer is "yes."