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Keeping up with the Dr. Joneses… and Other Ways to Sabotage Your Physician Job Search

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As an in-demand physician, the chances are pretty good that you have plenty of opportunities to consider when and if you are in the market for a new practice opportunity.  There is much more to think about when comparing opportunities than just base salary.  If you are experiencing feelings of burnout in your current position, then obviously you will want the new job to be structured differently.

Instead of jumping from the frying pan into the fire, choose an opportunity that is going to benefit your work-life balance rather than putting yourself into the same situation with a bigger salary.  Don’t fall into the trap of worrying about how much “so and so” makes, or what toys they have (The truth is they don’t have time to enjoy them!).

Focus on an opportunity that caters to the reasons you became a physician in the first place and allows you to enjoy the benefits of earning enough and having the balance to enjoy it all.  Let’s take a look at how physicians can weigh opportunities without worrying about keeping up with the Dr. Joneses.

Evaluate Your Options

How much is enough?  According to the BLS, wages for physicians are among the highest of all occupations.  Since there is such high demand for physicians, you should be able to find a position that has adequate compensation.  For you, personal motivations will play a greater role in answering the how much is enough question.

When moving to a new area, one of the factors that many people underestimate is the relative cost of living.  For example, some states have no state income taxes, others have very high taxes. The cost of living in a more rural area will be less than in a large urban area. For a quick thumbnail of how the cost of living compares between your current location and a new location, check out this cost of living calculator.

Another consideration that will impact your ideal salary is any current student loan debt and the plans for repayment.  According to the AMA, on average physicians are finishing medical school with close to $170,000 in student loan debt.  On the bright side, the National Health Services Corps is offering generous loan forgiveness grants and repayments for physicians entering certain specialties or relocating to underserved and rural regions.

The Bottom Line

Physicians in today’s healthcare environment should not be concerned about how much your annual salary is, but more about what you do with the money you earn, and if it is enough to fulfill your needs.  Are you planning to send your kids to private schools, take big annual vacations, or own property for camping getaways?  Whatever those personal goals look like, you should have the opportunity to make it happen.  The key is to have a sound financial plan and seek out the career opportunities that drive you closer to achieving personal fulfillment.

If you are ready to find a position that blends your financial needs with your personal needs, talk to a Jackson Physician Search recruitment expert today.  Or, to get a jump start on exploring any of our nationwide opportunities, check out our powerful job search tool here.

Read Between the Lines to Understand the 2018 Physician Compensation Surveys

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Each year, a variety of physician salary surveys are published with varying degrees of detail and context. Charts and tables deliver a wealth of information, but you need to read between the lines to understand how each report defines compensation and the larger trends driving it.

Here is a brief overview of recently published surveys to get you started.

Modern Healthcare Physician Compensation Survey

This leading media source publishes a round-up of compensation data for 23 specialties as reported by 12 organizations, from recruitment and consulting firms to industry associations. This three-page survey reports average starting salaries, rather than average incomes. Salary and bonuses are included, but insurance, stock options, and benefits are not. Data points include:

  • Average cash compensation for that specialty
  • Percentage change between the current and previous year

Key Takeaways:

  • Physician pay increases appear to be slowing, possibly due to the rise in hospital employment, where salary (vs. bonuses) make up most of compensation for physicians.
  • Although primary care specialties are among the lowest paid, they scored the highest average starting pay increases.
  • Emergency, internal, family, and hospital medicine physicians saw average year-to-year pay increases of more than 3%.

MGMA DataDive Provider Compensation Data

The Medical Group Management Association gathers W-2 data directly from practice managers at over 5,800 organizations nationwide, providing a dataset of approximately 136,000 providers. Their data offers a complete picture of over 140 physician specialties based upon practice size, region, metropolitan statistical area and more. Benchmarks include:

  • Compensation – Including total pay, bonus/incentives, retirement and more
  • Productivity – Work RVUs, total RVUs, professional collections and charges
  • Benefit Metrics – Hours worked per week/year and weeks of vacation

Key Takeaways:

  • Primary care physician compensation increased by more than 10% over the past five years.
  • Depending on specialty, the difference in compensation between states can be in the range of $100,000 to $270,000.
  • Family medicine physicians saw a 12% rise in total compensation over the past five years, while their median number of work relative value units (wRVUs) remained flat. This reflects higher signing bonuses, continuing medical education stipends, relocation reimbursement and other cash incentives to attract and retain physicians.

AMGA Medical Group Compensation and Productivity Survey

The American Medical Group Association survey represents more than 105,000 clinical providers. Participants are primarily large multispecialty medical groups and integrated health systems. The average number of providers per participant group was approximately 380. Data includes:

  • Compensation
  • Net collections
  • Work RVUs
  • Compensation-to-productivity ratios

Key Takeaways:

  • Although compensation per relative value unit (work RVU) was higher than average, 2017 was the first-year physician compensation increased by less than 2% in over a decade.
  • Compensation increased only +0.89%.
  • The national median showed a decline in physician productivity by a weighted average of -1.63%, possibly related to growing administrative burdens on providers.

Doximity Physician Compensation Report

Doximity is known as the largest medical social network in the country – with over 70% of US doctors as verified members. Their report draws on the responses of more than 65,000 licensed U.S. doctors in 40 medical specialties. Physicians who are verified Doximity users can access an interactive salary map to drill down on compensation data combined with housing cost insights.

Their public report focuses on year-over-year trends in:

  • Physician compensation across Metropolitan Statistical Areas (MSAs)
  • The gap in pay between male and female physicians
  • Absolute physician compensation across specialty, state, region, and gender

Key Takeaways:

  • There was a 4% increase in physician compensation nationally.
  • Less populated MSAs tend to have higher average compensation compared to larger cities.
  • The presence of large medical schools in an area ensures a stronger pipeline of doctors competing for a relatively fixed number of positions, which causes a dampening effect on compensation.

Medscape Physicians Compensation Report

Medscape is one of the most popular sources for physicians who use the report to access high-level salary trends and gauge how their peers feel about the challenges and rewards of practicing medicine. More than 20,000 physicians in 29 specialties responded to the online survey, and the results were weighted to the American Medical Association’s physician distribution by specialty. Information reported:

  • Annual Compensation by Specialty
  • Year-to-year Trends
  • Regional Averages

Key Takeaways:

  • Employed physicians comprised 69% of the respondent group versus 26% who are self-employed, with 5% not reporting.
  • Demand for specialists to help address behavioral health issues and the opioid crisis surged, highlighted by a year-to-year increase in psychiatry and physical medicine/rehabilitation.
  • Physicians cited altruistic reasons as the top three most rewarding parts of their job, with “making good money at a job I like” ranking fourth.

Physician Salary Calculator and Resource Center

To further contribute to the resources available to physicians, we offer a physician compensation resource center that includes an interactive calculator with data compiled from published industry sources, as well as proprietary data from our search assignments. Customizable calculator fields encompass the components that are typically included in a compensation package, including:

  • Benefits
  • Sign-on Bonus
  • Residency stipend
  • Relocation assistance
  • Student loan repayment
  • Bonuses for productivity and quality

The Physician Salary Calculator enables you to:

  • Easily access customized physician compensation data
  • Drill down by specialty, state, and type of location
  • Get instant results and have your report emailed to you

Your results will instantly show a competitive market-based scenario that breaks out base salary, benefits, hiring incentives and bonuses. The calculator is unique in its design for use with an offer in hand, or if you are considering relocation and want to see how far your current compensation would stretch in a different state or type of community.

In addition to the salary calculator, our resource center features relevant physician compensation articles and videos.

A Final Piece of Advice

For any practice opportunity, making an apples-to-apples comparison can be confusing. When negotiating, ask all the questions needed to fully understand the components of your compensation package. Industry insiders and experienced physician recruiters can be valuable resources. If you would like to speak to a recruiter, use the Contact Us form below.

Take Time to Assess Your Surroundings During Your On-Site Interview

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With competition for your services as a physician being so fierce, healthcare organizations are increasingly looking for individuals who fit their culture in addition to having the necessary skills to succeed.

While administrators are going out of their way to attract and hire doctors who are a good fit, it is important that you do the same for yourself. If you are being brought in for an on-site interview, it is a good indication that they think your values and skills are a match for the organization.  Don’t pass up the opportunity to do some reconnaissance of your own about the organization as well as the community.  Is it a place you can envision settling into?  A place you might even want to raise a family?  Fortunately, like anyone who is in a high-demand career, you have the opportunity to focus on finding a job that fits your career and life goals.

Think About Your Time Away from the Job

If you are going to avoid burnout, you have to have access to things that you like to do to recharge your batteries.  Do you like to fish and hike? Then check out your proximity to parklands.  Maybe you are a cycler or a runner.  You can search online for local running or bicycling clubs. Another underutilized resource for individuals who are relocating is the local chamber of commerce.  People work for the chamber because they know everybody in town and are connected to everyone who matters.  You can connect with them online, it’s a great place to start your research.

Spend Some Time in the Community

Make your way around the downtown or take a drive in the suburbs, it is important to get a feel for the speed and vibrancy of life there.  Strike up a random conversation with the person who is filling up their gas tank at the pump next to you.  You have made your career by gleaning health information from strangers, it is just as easy to learn about non-health related things in the same way.

Assess the Facility Environment

What are your thoughts as you walk through the front doors? Do the folks at the front desk have a smile on their face?  How about the other clinicians?  What can you read from their body language?  Head over to the coffee shop or the cafeteria and strike up a conversation with any physicians or residents you come across.  You might be surprised what you can learn from a little human intelligence, and it will help you in the interview process.

Now, that you have your own sense of the community, the facility, and the people who work there, there is a frame of reference for you to lean on during the interview.  You may have learned something that you want to confirm or ask about. The members of the interview team will measure you up at the same time you can measure them against your recon experience. While it may feel a bit like a spy novel, we are talking about your career and your happiness and engagement in that career.

Jackson Physician Search recruiters personally visit their client’s location so they can help candidates accurately evaluate fit.

If you want to know more about any of our physician opportunities, please contact us.

How To Advance Your Physician Career With a New Job

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As you look to advance your physician career with a new job, the most important question you must ask yourself is why are you considering a change?  Your reasons will drive how you approach your job search and help you make the best decision when evaluating opportunities.

Physicians and Advanced Practice professionals are living examples of how supply and demand works based on the wide variance between current need and the number of practicing caregivers. In 2015, the Association of American Medical Colleges commissioned IHS Inc. (now IHS Markit), to analyze the state of physician supply and demand through 2025.  According to the report, based on demand, the deficit of available physicians will be between 46,100 and 90,400 by 2025.

What this means for doctors and advanced practice providers is that opportunities are plentiful and competition for your services is higher than ever.  The time is right to advance your career with a new job.  Here are things to consider:

Finding the right fit for you and your career.

Fortunately, having chosen a career that is in such demand, you have plenty of options.  Hospital administrators are finding out that culture and fit are far more important to physician retention and engagement than ever before considered.  For you, this means that you can take the time to weigh your options and select a position that fits your personal or professional life.  It also means you can take a position across town or across the country.  If you’re looking for a lifestyle change, chances are there is a position available to facilitate that change.

Step up the career ladder.

Have you reached a point in your career where you want to have more say in how things are done in the workplace?  Many experienced physicians are deciding to explore leadership positions. As a physician executive, the leadership and management within healthcare organizations is a natural next step.  Hospital systems, medical schools, even insurance companies all need leaders with your skills and experiences. If you envision being in the C-suite one day, the time to begin that climb is now.

Shape the next generation of healthcare professionals.

If you still enjoy patient care but need a change from day to day patient-facing positions, teaching the next generation of physicians may be an option. You can impart your wisdom and experiences to third- and fourth-year medical students, train residents in their specialty, or teach physician assistants.

No matter which direction you want your career path to take, the good news is that the job market is robust and anyone who is committed to making the most of their career will have ample opportunity to do so.  Take some time and brush up your CV or resume.  You can ease the burden of searching for a new job joining forces with an experienced physician recruitment team like Jackson Physician Search.  Our physician recruitment experts take the time to understand your needs, and our nationwide reach means that you will be exposed to the opportunities that provide you with the best fit for your future.

If you’re ready to get started, browse our current physician opportunities.

 

What Physicians Can Do to Avoid Burnout

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We have all experienced feelings of burnout at different points in our career, being overwhelmed, depressed, and other negative reactions to our work.  For our nation’s physicians, according to recent surveys, these feelings of burnout are pervasive and seemingly getting worse.  In fact, in a 2018 Medscape report, almost half of physicians surveyed reported suffering from symptoms of burnout.  When a doctor is suffering from burnout, naturally the quality of patient care suffers.

The reasons for a doctor feeling the effects of burnout vary between large systems and small and differ between specialties, but common themes exist when the causes are discussed.

  • Today’s physicians will almost unanimously assert that they spend far too much of their time performing clerical tasks. A time study sponsored by the American Medical Association showed that for every hour a physician spends with patients, they spend up to two hours creating notes, documenting phone calls, ordering tests, reviewing results, and other non-patient-facing functions.
  • Physicians feel disillusioned because other tasks take away from the reasons they went to medical school in the first place. You practice medicine because of your desire to treat and help patients.
  • The added burden of clerical tasks and non-patient related activities is causing doctors to spend too much time “off the clock” and on their own time performing documentary tasks. Physicians are losing control over their personal time with family and losing the battle for life-work balance.

The extent of physician burnout is well-documented.  Across the country, hospital system leaders are finally treating it as the challenge that has become.  Let’s look at a few ways that physicians can cope with feelings of burnout.

  1. Recognize the symptoms and admit when there is a problem. Physicians are often looked at as “Superman” and “Wonder Woman” because of their heroic efforts to save lives and the commitment they have made to years of education and residency to earn their place as healthcare professionals. It is important for doctors to recognize the signs of burnout and take action.
  2. Get involved. Modern healthcare system administrators, hospital executives, and others in the “C-Suite” recognize that there is a burnout problem and most are actively working on ways to solve the problem.  Be a part of the solution and lend your voice to potential solutions.  Physician burnout will never be solved in a vacuum, and it is too critical an issue to leave it for someone else to solve.
  3. Take vacation time. When the time rolls around for your vacation, a single week is not enough to recharge your batteries. Two weeks is a more appropriate amount of time to fully disconnect from the workplace and enjoy quality time with your loved ones. You might even have the option to take a sabbatical.
  4. Diet and exercise. Doctors spend a lot of time counseling their patients that the key to a healthier life is through diet and exercise. That is such good advice, medical professionals should heed it themselves.  Medical studies have shown regular exercise can reduce feelings of stress and depression.  Further, eating healthier and balanced meals will promote better energy and help maintain ideal body weight.
  5. Talk to a mentor. Having a mentor is advisable for every type of career.  After all, it is always helpful to talk to someone who may have experienced the same things or has navigated difficult times in their career. A mentor is someone who can be used as a sounding board for ideas or just be there to listen and interject sage advice.  Holding stress or feelings of burnout inside will cause those feelings to escalate talking about them with someone is always helpful.

Physician burnout is real and finding ways to alleviate the growing problem is a concern for the entire healthcare community.  Each organization needs to understand the levels of burnout being experienced by their teams and work to determine the root cause.  Developing new systems, redesigning clinical procedures, and improving the physician work environment is going to be a team effort.

Put the Flame Out on Physician Burnout

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Summer is in full swing with backyard barbecues, kids splashing in the pool, and friends and family are gathered around the yard chatting about last night’s little league game.  Laughter fills the air until you turn towards the grill to find smoke billowing out the sides.  Oh no, the burgers are flaming out, and you were too distracted to notice it happening.

While this is all too familiar with backyard chefs, the same thing may be happening to the physician in your healthcare system.  Recently, Stanford University School of Medicine anonymously surveyed almost 7,000 physicians, and the results were alarming.  More than 55% of those doctors reported experiencing symptoms of burnout, and 33% reporting high levels of fatigue.

It isn’t much trouble to replace the burgers that have burned out on the grill but losing physicians to burnout is much more serious and can cost millions!  The biggest mistake hospital administrators can make is ignoring the problem and hoping that it takes care of itself.  Organizations need to take an all-hands on deck approach to recognizing when burnout is impacting the medical staff, and most importantly what can be done to alleviate the problem before it becomes insurmountable.

Jackson Physician Search published a study focusing on the state of physician alignment with their employers, called The Physician Engagement Gap.  When physicians are engaged in the organization and are aligned with the company values and culture, they are happier and more productive. Unfortunately, the study shows that the levels of physician engagement have not changed positively over the past decade. Worse, hospital executive’s perception of physician engagement is higher than in reality.

There is no magic solution for combatting physician burnout.  Each organization may have a different solution or may have to create their own best practices to engage the team and create positive lasting change. Here are a few broad concepts that can be used to jumpstart your burnout prevention efforts:

  • Treat physician burnout as the serious problem that it presents to your organization.
  • Engage your physicians as part of the solution. Find out what issues or frustrations they have that are standing in the way of patient care. Much like lean manufacturing, continuous improvement through the fixing of broken patient care processes builds trust and relieves sources of frustration.
  • Understand that your team’s satisfaction is being impacted by Electronic Health Records. Work towards solving EHR frustrations and your physicians will free up more time for patient care and new patients.
  • Develop, Support and encourage participation in a Physician Wellness Program.
  • Actively work to cultivate and improve relationships with your physician team.

Lastly, the next time you are planning a backyard barbecue, think about starting similar gatherings for your team.  Smaller gatherings are always effective ways to promote the social aspects of team building.  In these smaller settings, you are exposed to people in a more relaxed setting and may learn more about who they are and what drives them to be healthcare professionals.  You might be surprised by how much you don’t know about them, but glad you learned.  Oh, and don’t forget to keep an eye on the burgers!

State of Addiction: How Healthcare Leaders and Physicians Can Address Georgia’s New Measures

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Across the United States, opioid overdoses led to 42,249 deaths in 2016,[i] a toll that could rise to nearly 500,000 deaths over the next decade.[ii]

On a state-by-state basis, legislatures and healthcare organizations are grappling with emerging social issues around pain management, including the use of medical marijuana and the tragic consequences of addiction to opioid medications. In Georgia alone, there were 1,462 overdose deaths in 2016, of which 67% were due to opioid overdoses.[iii]

Michael Byman, Director of Jackson Physician Search, led a discussion with members of the John’s Creek Medical Association about how healthcare leaders can support their medical staff as they comply with Georgia’s recently enacted regulations related to medical marijuana and prescription painkillers.

A Snapshot of Recent New Rules

Georgia recently expanded the law that protects patients from criminal prosecution for possessing low THC oil for medicinal purposes for specific conditions. However, the law does not authorize physicians to prescribe marijuana for medical use or authorize retail stores to sell products made from the marijuana plant.

In the case of opioids, the Georgia Attorney General’s office reports that 531 million opioid doses were prescribed to Georgia patients in just one year, equal to approximately 54 doses for every man, woman, and child in the state.[iv]

To address the problem of opioid abuse, the Governor’s office launched the Statewide Opioid Task Force, providing an infrastructure of communication between organizations in the public, private and non-profit sectors. The legislature has also enacted new laws including regulations that compel physicians to do more thorough research on their patient’s prescription history.[v]

Georgia’s response has earned recognition from the National Safety Council for being one of 13 states receiving the highest mark for taking comprehensive actions to eliminate opioid overdoses, improving from a “failing” designation in 2016.[vi]

Impact on Providers

Interdisciplinary teamwork among physicians, advanced practice providers, therapists, administrators and others is required to address pain management and other therapies intended to relieve debilitating symptoms. They must follow medical protocols and comply with the web of changing and conflicting regulations, all while keeping the patient at the center of their focus.

The result is a growing burden of education, communication, compliance, and reporting, requiring new skills that are in short supply and more time that is not reimbursable. The challenge is compounded by the worsening shortage and urgent demand for physicians caring for patients for whom controlled substances should be used – but may be tragically abused.

Byman painted a clear picture showing that active job postings in Georgia far outnumber the available candidate pool in specialties such as primary care, psychiatry, physical medicine and rehabilitation, and pain medicine.

Long-term solutions to expand residency and fellowship programs are not fast-acting enough to relieve the current strain on the system.

Inside the statistics, are the stories of doctors struggling to stay positive and motivated to help their patients manage pain and overcome debilitating symptoms while abiding by Georgia law and the Hippocratic Oath.

One physician recently wrote about the first time he ever “hated a patient.” She had “weaponized [her addiction] and would expertly wield it against everyone standing between her and her pain medication.” For him “true empathy, perhaps especially in the current healthcare environment, is a tool that requires constant sharpening.”

Beyond Compliance, What Can We Do?

Working within the realities of this environment, Byman offered practical and effective strategies that are helping many healthcare executives and physicians address the shortage of physicians and answer the question: “Beyond compliance, what can we do?”

Add Advanced Practitioners to your Team: The advanced training of physician assistants and nurse practitioners – many with specialty certifications – can make a significant difference. When you make them an integral part of the team, they are well-suited to assist with the additional patient communication, prescription history and necessary follow-up required by today’s regulations.

Embrace Telemedicine: There is an acute shortage of physicians willing to relocate to small towns and remote communities, or to spend time on the road to staff clinics there. At the same time, studies show that patients and families are rapidly accepting telemedicine and report high satisfaction with it when used effectively. Physicians at all stages of their careers are becoming very comfortable with technology and deliver significant value when diagnosing and treating patients even when not at the bedside.

Hire for Fit: The times are changing, and so must your criteria when recruiting new physicians. Carefully assess the motivations and values of your candidates build (and keep) a team of mission-driven physicians and advanced practice providers who will fit your culture and make a difference for your patients.

Educate and Engage the Community: From the top of the organization through the front lines, organizations are accepting their role as leaders in delivering authoritative information about how to benefit from therapies using controlled substances – while identifying and avoiding the danger of abuse. An outreach program to specialists, health centers, patients, and schools gives everyone some ownership in the solution – an essential step in solving the problem.

For help in building your team in key specialties to address this growing health problem, please contact us.

 

[i] Henry J Kaiser Family Foundation, Opioid Overdose Deaths, https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-gender/
[ii] STAT forecast: “Opioids could kill nearly 500,000 Americans in the next decade,” https://www.statnews.com/2017/06/27/opioid-deaths-forecast/
[iii] Georgia Department of Public Health, https://www.moveforwardpt.com/Resources/Detail/opioid-abuse-statistics-of-50-states-2
[iv] Georgia Office of Attorney General, “Opioid Abuse,” https://law.georgia.gov/opioid-abuse
[v] Georgia Office of Attorney General, “Op-Ed: Carr Continues Efforts to Strengthen State’s Response to the Opioid Epidemic, April 17, 2018, https://law.georgia.gov
[vi] National Safety Council, “Just 13 States and D.C. Are Adequately Addressing the Opioid Crisis,” April 10, 2018, https://www.nsc.org/

 

How to Make Your Next Physician Practice Feel like a Vacation

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If that headline grabbed your attention, it’s likely that you are either on vacation or wish you were! By definition, vacation is the time you spend on travel or recreation – away from work. So, how is it possible to make your next physician practice feel like a vacation?

If you pick the right practice in the right place, it is possible to enjoy some of the feelings, sensations, and experiences you have on vacation on an everyday basis.

It takes a bit of personal introspection and a good guide who can help you align what makes you happy on vacation with a job that delivers those same satisfiers both within the practice and outside of work.

First, take inventory of what you love about vacation (other than not being at work)!

  • Time: How do you spend your time on vacation? Do you plan to see, do or learn new things? Do you enroll in a course or take on a project? Do you recharge through reading, contemplation or the fine art of “doing nothing”?
  • People: Describe the energy you get from the people you are around when vacationing. Do you find solitude restorative, or do you enjoy traveling with a group? If you have a family, what are things you do together, and how do you like to spend any alone time?
  • Surroundings: What are the must-haves for your vacation destinations? Do they include access to water and mountains, or nightlife and culture? Do you relish challenging exercise or spa treatments? Are you all-in for local cuisine, history and notable sites? Maybe there is a hobby or special interest at the top of your list.

Next, explore how a potential practice opportunity and community align not only with “Dr. You,” but also with “Vacation You.”

Do not be afraid to ask your recruiter lots of questions. They understand that your medical skills – which can be applied in nearly any setting – are in high demand. Their goal is to differentiate each opportunity by showing you how they can meet your goals for quality of practice and quality of life.

Give them plenty of insight about your priorities so that they can customize the schedule for your interview. You will need ample opportunity to see how the amenities and culture – of both the organization and the community – will contribute to your overall work/life experience. Remember, you want to see and hear about the things that will evoke the same energy you feel on vacation.

Is the practice team-based or mostly autonomous? What group activities or committees are part of the job? Is time available for research, continuing education, medical missions or sabbaticals?

Does the facility offer yoga class, hiking trails, a meditation garden or gym? If there is onsite daycare, you may be able to drop in for lunch or special activities with your children. Do colleagues and their families enjoy any similar hobbies and interests as you and your family?

The U.S. is full of best-kept secrets. Some may be minutes away from fishing, horse trails, wineries or water sports that you normally must wait to enjoy on vacation. There may be fabulous dining and entertainment nearby that will make weekends special, or enough local history to allow you to be a tourist in your own town.

When you identify the restorative aspects of vacation that are unique to you, the choice of practice opportunities will become clear. The sum of positive team dynamics, small daily pleasures, local amenities and weekend excursions will go a long way toward making work feel more like a vacation.

Jackson Physician Search recruiters personally visit their client’s location so they can help candidates accurately evaluate fit. If you want to know more about any of our physician opportunities, please contact us.

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RVUs and the Future of Physician Compensation Models

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Recent surveys are showing a growing shift toward value-based incentives as a component of discretionary compensation, but production in the form of work RVUs are still the most prevalent salary factor.  To review, Relative Value Units (RVUs) are based on a scale originally designed to determine reimbursements from Medicare and/or Medicaid. RVUs represent a calculation of the effort expended by a physician when treating patients as a reflection of the time, skill, training required, and intensity of the service being performed. Using RVUs as a measure of productivity has been widely accepted because the scale reflects the reality that patient interactions are not equal.  For example, a physician treating complex or high acuity patients will earn more RVUs than one who treats ten low acuity patients in a day. For up to date RVU values, you can download the 2018 Physician Fee Schedule from the Centers for Medicare and Medicaid Services.

Primary Care Physicians are in demand throughout most of the United States, even though the recent Medical Group Management Association (MGMA) Physician Compensation Report results are not reflective of a high-demand market. The MGMA report along with the American Medical Group Association (AMGA) Compensation Survey show that physicians are receiving annual increases in the range of 1% to 4% depending on the specialty.  These modest increases are expected to continue in spite of the projected physician shortfall of between 42,600 and 121,300, as reported by the Association of American Medical Colleges.

According to the MGMA survey, the annual median reported RVUs was 4,928 in family medicine, 4,698 in internal medicine, and 4,902 in pediatrics.  Both the MGMA compensation survey and AMGA survey reported flat productivity in family and internal medicine, although pediatric RVU reports differed.  The AMGA survey results show a decline in median pediatric RVUs while the MGMA survey indicated a measurable increase in pediatric productivity.

The latest challenge for healthcare industry administrators has been adjusting physician compensation to model the shift toward value-based measurements.  In 2009, approximately 41% of medical groups related that at least some of their physician compensation had a value-based component as opposed to 60% in 2016.  Overall, value-based pay accounted for less than 7% of a physician’s total compensation.

As is often the case, Medicare/Medicaid reimbursements are driving much of the healthcare industry changes.  For example, look no further than the 2016 passage of the Medicare Access and CHIP Reauthorization Act (MACRA) which builds upon many of the payment and delivery reforms that originated with the passage of the Affordable Care Act. One of the stated goals of MACRA legislation is that 85% of all Medicare FFS payments will be tied to quality by the end of this year.

It may not be too radical to envision future physician compensation models that do not contain an RVU/production component.  More likely, as health care reform measures continue to push greater access, drive value over volume, and control reimbursement levels, RVUs may become largely irrelevant.

Are you having difficulty with physician compensation?  Our team at Jackson Physician Search can help.  Contact us today to learn more about our team of industry experts and what we can do for you.

Pros and Cons of Physician Compensation Models

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While the business of healthcare grows increasingly complex, fortunately, physician compensation models have generally become less complicated over time.  Even though there are still many different payment models in use, physician compensation structures are easier to manage and understand then they were in the past.  Physician payment models will never be a one-size-fits-all proposition for health system administrators.  The following is a brief synopsis of the pros and cons of the most popular physician compensation models.

Straight Salary

Using a preset level of income for physicians is the easiest model to understand.  Typically, the physician is contracted to achieve defined levels of productivity and quality.  On the pro side of a salary model, the physician has a sense of security and a guaranteed level of income.  The con aspect is that a straight salary model does not encourage innovation, or cost reduction efforts.

Salary Plus Bonus

As a means to encourage physicians to increase income, reduce costs, or achieve other predefined performance metrics, a salary plus bonus payment model may be in use.  It achieves the benefit of providing physicians with a guaranteed salary while also having an opportunity to earn a bonus. There aren’t as many cons with this popular method of compensation, although it is critical to determine the appropriate metrics for structuring the bonus.

Equal Shares

The equal shares model of compensation divides revenue equally among the group of physicians after expenses are covered.  This method is most common in smaller medical groups or specialty practices. One of the pros of an equal shares model is that there is a natural aversion to the overutilization of resources.  A downside of this payment model is that there is no incentive for creating efficiencies or higher productivity. In some cases, conflict is created when there is a perception that one or more of the group are under producing.

Pay-for-Performance

More physicians are finding that systems are implementing variations of a pay-for-performance model as a way to tie financial incentives to the achievement of predetermined performance goals.  An obvious benefit to this payment model is that achieving critical performance and quality targets are incentivized.  Physicians are being encouraged to innovate.  On the downside of pay-for-performance models is the complexity and administration of the program.

Productivity-based

Another payment model with many variations is productivity-based compensation.  In this model, physicians receive a percentage of their billings, or they are paid according to a scale that is based on procedures being performed or the type of patient visit. This scale, the resource-based relative value scale (RBRVS) assigns units to each activity a physician performs, called relative value units (RVUs).  An advantage of productivity-based models is that physicians are rewarded for extra effort, and they are also encouraged to be mindful of excessive overhead costs.  A negative result of RVU models is that it may lead to an overly competitive environment between physicians. Another criticism of this model is that while effort is rewarded, there is less consideration of outcomes.

While every compensation model currently in use has not been covered here, it is clear that are many different ways that physicians are being paid for their work.  Pay will always be a factor in determining your next career move, so it is important to understand how your salary is being determined.  Stay tuned to the Jackson Physician Search Blog for a deeper dive into compensation plans that are determined on RVUs.

Our team has decades of physician compensation experience. For personalized information about what we can do for you, contact us today.