Looking for Your Next Job? Understanding Physician Compensation, Benefits, and Bonuses

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This article is Part III in a series dedicated to helping physicians plan their next career move. Click here for Part I and find Part II here.

Medical school training is both comprehensive and exhaustive for today’s physicians, and the one area that too little time is spent talking about is compensation.  After all, physicians don’t want to spend almost ten years training for a career and not have a clear understanding of how they are going to be paid.

Part of the challenge in understanding physician compensation models is that they vary across the board. Often times, when weighing one job opportunity against another, it is difficult to make an apple-to-apple comparison regarding the salary structure.

Hopefully, by the time you reach the end of this article, you will have a better understanding of the different types of compensation packages and will feel more confident in negotiating an offer that is fair and aligns with your personal and career priorities.

Types of Compensation Packages

Straight Salary

Without question, the easiest compensation model to understand, in any industry, is the concept of a preset level of income for the hours and work that you perform.  To support the salary level, physicians are typically required to achieve pre-defined, reportable metrics, such as productivity and quality.  With a straight salary model, physicians will have a sense of security due to the guaranteed level of income, but may not be motivated to pursue innovation or cost reduction initiatives.

Salary Plus Bonus

As a mechanism to encourage innovation, reduce costs, or achieve other performance metrics that aren’t tied to a guaranteed salary, administrators often implement a bonus structure on top of the straight salary.  For many healthcare organizations, this is a popular method of physician compensation. An important consideration for physicians negotiating the bonus portion of the offer is to ensure the appropriate metrics are included and are transparently reported regularly.

Pay-for-Performance

One of the more complex and administratively burdensome pay structures is the pay-for-performance model.  Health systems are increasingly moving to tie financial incentives to the achievement of predetermined performance goals.  This model has an obvious benefit to the organization as physicians are being incentivized to achieve performance and quality targets.  Pay-for-performance models also succeed in motivating physicians to find innovations and efficiencies.  When this type of compensation model is contained within an offer, it is important for physicians to understand all of the individual components that are going to be impacting their salary.

Value-based Measures

Ever since the enactment of the Affordable Care Act, the healthcare industry has been evolving toward value-based outcomes.  Similarly, physician compensation models are gravitating toward value-based compensation.  In the past, physician compensation was often driven by patient volume and the number of procedures performed.  Today, many other factors are included, such as costs of care, patient experience, coordination of care, quality, and productivity.  And, while productivity still comprises the largest factor in physician compensation, a mix of value-based factors can contribute up to 20% of total compensation.

RVUs

Another trend that was more pronounced after the passing of the Affordable Care Act was a move toward mergers and consolidations across the healthcare industry. Relative Value Units (RVUs), a concept introduced in the 1990s, have not only played a role in physician compensation, but also in determining the value of medical practice buyouts and mergers.  In its simplest form, an RVU accounts for physician time, technical skill and effort, mental effort and judgment, and stress as components of providing a service.  Some physician compensation models use a base salary, but add to it a bonus factor that is based on the number of RVUs generated.  This is another example of a compensation structure that needs to be carefully studied when considering employment offers.

Stacking

When a compensation model includes stacking, physicians can be sure that it will have a higher level of complexity.  Stacking occurs when a physician is performing multiple roles and being compensated for each individually.  For example, hours spent working as the medical director or other leadership capacities will be paid at a different level then hours worked in their regular capacity.  This type of arrangement can serve as a motivator for doctors who may be considering a leadership position, or possibly a move to a different position altogether.  Stacking models can lead to higher compensation for physicians but is more challenging to track to ensure you are being paid for work performed.

Guaranteed Salary

Just looking at the name, physicians may think that this compensation model is the most straight forward and easiest to understand.  Not necessarily.  In some cases, your contract may state that you are 100% guaranteed to earn a specific salary annually.  In other contracts, your guaranteed salary may be a lower overall number that is guaranteed but includes incentive triggers that allow you to increase your compensation.  Just because the name suggests a guarantee, it is still wise to have your lawyer examine the contract to ensure you understand what is guaranteed.  Whenever incentives are involved, it is important to understand how the RVUs are calculated and how they are tied to your salary.

Common Bonuses

As we have discussed, in most compensation models, your compensation doesn’t consist solely of a base salary.  Most employers combine an agreed-upon salary with variable components that affect total compensation. You need to determine – and be comfortable with – how much of your pay will be based on your individual performance, organizational performance, and other factors like patient satisfaction. It is fair to ask how those variables have affected compensation in recent years – and why.

Bonuses are playing an essential role in physician compensation.  They can be productivity-based, quality-based, or a combination of both.  Factors that impact a healthcare organization’s bonus structure include payer mix, overhead costs, percentage of self-payed patients, RVUs, and more.  Let’s take a closer look at how bonuses can be used in a physician’s compensation package.

Quality Bonuses

As mentioned above, the passage of the Affordable Care Act ushered in a new era in healthcare, where more emphasis was placed on the quality of care.  Healthcare administrators are increasingly looking for ways to incentivize the achievement of quality indicators.  Part of that effort is in the form of quality bonuses for physicians.  Quality bonuses can be tied to many factors, such as patient satisfaction, throughput time, paperwork/medical records completion, etc.  One way a physician can determine the fairness of the quality bonus structure is to ask what percentage of employees are earning the quality bonus. This will give you an indicator of whether the bonus plan is achievable.  You will also want to know how often the bonuses are paid out, as some are quarterly, bi-annually, or annually.

Sign-on Bonus

As the physician shortage continues to drive up the competition for services, sign-on bonuses have become a differentiator for healthcare organizations when filling vacant positions.  Something for physicians to consider is that sign-on bonuses are impacted by geographic location.  In some areas, physicians can expect signing bonuses of up to $40,000. By contrast, in other localities, bonuses of $10,000 or less are common.  Physicians who are not tied to a specific location can seek out more lucrative offers if they are willing to relocate.

Student Loan Forgiveness

Most physicians finish medical school training with an incredible amount of student loan debt.  That kind of pressure adds stress to a young physician who is starting their career.  Student loan forgiveness and assistance is another way healthcare administrators are attracting physicians to fill their vacancies.  In most cases, a physician will receive a set amount of student loan assistance for a contractual commitment to stay in the position for a number of years.  In the past, student loan forgiveness was a key drawing card for rural and community health systems to aid their recruitment efforts.  Now, as the competition for physician services becomes fiercer, organizations in all settings are using student loan forgiveness as a recruitment tool.

Retention Bonuses

As the costs to recruit and hire physicians continue to escalate, healthcare administrators are paying more attention to finding ways to keep the doctors they already employ. One way administrators are addressing this is through the implementation of retention bonuses.  These bonuses are typically paid at periodic intervals throughout the length of an employment contract, but some are held until a physician has completed the entire agreed upon term.

Benefits

Malpractice/Liability Insurance

Arguably the most popular benefit that healthcare organizations are providing to their physicians is insurance against malpractice claims.  These benefits can include variable coverage limits and other claim specific details.  This is another essential clause for your lawyer to review, so you understand your coverage, limitations, and what happens should you leave the position.

Relocation Stipend

Many healthcare organizations are sweetening their offers by offering relocation benefits to physicians who are willing to move to a new location to accept a job offer. Relocation benefits are typically negotiable based on the geographic area and other location-specific circumstances.  Physicians should be sure to understand the specifics of what is required to earn the stipend and how it will be paid out.

Miscellaneous Benefits

Other bonuses and stipends can be available but are less common.  In some geographic locations, physicians may be offered a vehicle stipend, housing allowance, parking stipends, and more depending on specific challenges in that area.  Other benefits include paid time off (PTO), retirement plans, health insurance, and continuing education programs.

Recruiter Help

Throughout the years of medical training, the person a physician relies upon the most, is themselves.  Physicians are naturally born problem solvers, and most are fiercely independent.  One time that being self-reliant should be reconsidered is during a job search.  When a physician is ready for their first position or seeking the next step in their career, a recruiter can help navigate the myriad of unforeseen challenges.  A trusted, experienced physician recruitment professional will have access to open positions that you may not find on a typical job board.  They will be with you every step of the way throughout your search and can provide you with critical information about the organization, the leadership team, geographic considerations, and compensation expectations.

The key is to find a reputable physician recruitment firm.  One that has a nationwide network and experienced healthcare industry professionals who can help you find the best fit for your personal and professional goals.  Your recruiter is a great sounding board and can help you polish up your CV and provide you with the tips you need to ace the interview process.  When it comes time to negotiate an employment offer, your recruiter can give you seasoned insight into what to expect, how achievable the bonus structure is, and a number of other details that will impact your earnings.

To connect with a nationally recognized physician recruitment firm, reach out to the healthcare industry professionals at Jackson Physician Search today.

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Quick Look: Physician Retention Tips

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Each year, the Association of American Medical Colleges (AAMC) updates their report outlining projected Physician Supply and Demand for the United States.  The most recent report is projecting physician deficits between 42,600 and 121,300 by the year 2030.  As in years past, primary care physicians represent the largest shortfall with estimates as high as 49,300.  Surgical specialists are not far behind with a projected shortage of up to 30,500.

If nothing else, these projected physician shortages highlight the importance for healthcare administrators to ensure that their organizations are utilizing best practices in their physician recruitment and retention policies.  In today’s highly competitive physician recruitment environment, the best way to ensure that your organization avoids lengthy physician vacancies is to minimize turnover.

Here is an overview of eight retention strategies that every healthcare organization should be practicing now.

  1. Focus on Making Good Hires – One of the best ways to give your organization a better chance at retaining the physicians you have on staff is to make sure you are hiring for fit and not hiring to fill. Ensuring that your recruitment process targets individuals that are already aligned with your organizational values gives you the best opportunity to keep them engaged and not seeking greener pastures.
  2. Develop a Culture that Feeds Retention – By now, you should be well aware of the role that organizational culture plays in physician retention. Poor work environments and dysfunctional communication is the surest way to alienate the physicians you have on staff and will lead to a revolving door of vacancies.
  3. Help Your Physicians Stay Engaged – In any work environment, when staff is engaged they exhibit more loyalty to the organization, they are better at working through issues, and consistently put forth greater effort than employees who are not engaged. According to Gallup, fully engaged physicians generate more outpatient referrals and a whopping 51% more inpatient referrals than non-engaged physicians.
  4. Provide Personal Growth Opportunities – According to Medscape’s 2018 National Physician Burnout & Depression Report, 42% of physicians reporting feeling burned out while 15% admitted feeling varying levels of depression. Keep your physicians engaged by encouraging them to pursue the things they are passionate about.
  5. Allow for Career Advancement Opportunities – The Physicians on your staff have spent many years of schooling to reach their current position, and it is a mistake to think that they are now on cruise control. Collaborating on a plan that affords them the flexibility to pursue their career goals will benefit your organization and ultimately make them better doctors.
  6. Promote Work/Life Balance – Physician burnout is dominating the headlines on medical news outlets, and it is reasonable to assume your physicians are experiencing those same issues. It is critical for administrators to engage their physician staff to develop solutions. The Mayo Clinic developed a model to reduce burnout called the “Listen-Act-Develop” approach.
  7. Compensation – According to Kresser Institute, forty percent of medical school graduates finish with more than $200,000 in student loan debt. Organizations cannot ignore this intrinsic pressure on their physician staff and should explore creative ways to ensure that financial pressures are not contributing to physician burnout.
  8. Encourage Time Off/Family Time – When physicians are asked directly about what would help them the most in dealing with workplace pressures, most will respond that they need more time off and more manageable call schedules. A healthy family life can be a physician’s best defense against burnout and depression, and a supportive administration can help foster physician well-being.

As the physician shortage continues to impact healthcare organizations across the U.S., retaining the physicians you have on staff is going to be increasingly more critical to keeping up with the projected demand.  The question for healthcare executives is whether or not to spend the time, effort, and money on developing a successful retention program or on a continuous cycle of recruitment and hiring to fill avoidable physician vacancies.

How Millennial Doctors are Changing the Recruitment Landscape

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In the United States, it has been a long-held practice to attribute generational monikers to individuals based on the year of their birth.  If we look at that breakdown, it makes sense to see that the number of physicians is relative to the population of the generational mix.  For example, in the U.S., 76 million people were born between 1946 and 1964, these baby boomers also represent the largest numbers of practicing physicians.  Studies show that over 40% of the nation’s physicians are over age 56.  The second largest generational mix are the millennials, with 62 million born between 1981 and 1996.  As the Boomer generation ages and retires, the Millennials are increasingly representing a greater proportion of physicians in the U.S., and there is a good reason why that matters with regard to recruitment.  Let’s look at how recruiting millennial physicians is different than past generations.

Digital Recruitment is Key

Unlike other generations, millennials grew up in the technology boom.  Doctors born in the millennial era are going to be more reliant on and more accessible through technology than their Gen-x or Baby Boomer counterparts.  Because they are so connected through their smartphones, laptops, and other tech gadgetry, your utilization of a smart digital recruitment strategy will keep you ahead of the curve.

It’s Not Always About Money

Of course, millennials worked hard in school and want to be fairly compensated for the work they are doing, but recruiting them will not be solely based on a dollar amount in their paycheck.  While they are sometimes inaccurately maligned by older generations as not being committed, or lacking drive, the truth is the opposite.  According to Deloitte’s 2018 Millennial Survey, over 50% of the respondents placed greater or as great a value on quality of life issues over the highest salary. Millennials are looking for more flexible schedules, guaranteed time off, and less time on call.  To recruit the millennial generation, work/life balance should play a prominent role in any job offers.

Don’t Overlook Culture and Fit

Much like millennials seeking greater work/life balance over annual salary, they also have strong opinions about how important it is for them to feel connected to the culture and values of their workplace. Millennials were raised in the era of participation trophies where teamwork and affirmation were valued above individual success. They are looking for the same in their work environment.  Millennial physicians are comfortable with the trend toward team-based care and are drawn to organizations that are aligned with their own personal values.

Focus on Retention

Because culture and fit are such vital factors in the millennial physician’s job search, it is no surprise that it plays a significant role in physician retention. Older generations of physicians are prone to stay in a job for a decade or more, with little to no thought of leaving. The millennial generation of physicians will seek out new opportunities after only two or three years.  To combat this tendency, healthcare organizations are more focused on finding a physician that first fits their culture, and then they develop a strategic plan to retain them.  Successful retention strategies include affording them time to pursue research projects, or branch out into additional specialties, and pursue charitable endeavors.  They key is keeping your physicians excited and engaged and not giving them a reason to look for greener pastures.

If your organization needs to develop a digital recruitment and retention strategy, contact the industry experts at Jackson Physician Search today.

Guide to Strategic Digital Recruitment

Our Regional Vice President of Recruiting, Christen Wrensen, presented the Digital Recruitment Strategy Guide to members of the Texas Hospital Association at their 2019 annual conference.

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Understanding Physician Bonuses and Benefits

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Physician salaries continue to rise, although more modestly than in years past. You may find that hard to believe considering the 24-7 handwringing over the physician shortage, but have no doubt that physician compensation is still rising and becoming more complex.  After all, it is simple economics, as demand rises and supply stays the same or fails to rise commensurately, the cost (in this case salary) is going to rise.  For example, according to Medscape’s Physician Compensation Report 2018 average salaries for Primary Care and Specialties rose between 3 and 5% from 2017.  Hospitals and health systems are finding other ways to compensate physicians than base salary.  Many bonuses and benefits are not available everywhere but are often based on setting and geographic area.  Let’s try and make sense of some of the more popular physician bonuses and benefits.

Guaranteed Salary

This is one piece of your compensation package that is helpful to have your lawyer examine. Depending on your contract, this may be a 100% guarantee that you will earn X annually, or there may be a lower annual guarantee that includes incentive triggers that when met will increase your overall compensation. When incentives are involved, you will want to understand RVU’s and how they are tied to your salary.

Sign-On Bonus

The competition for physicians across the spectrum of care has led to an increase in the prevalence and amount of sign-on bonuses.  Depending on geographic location, physicians may be seeing signing bonuses up to $40,000. On the flip side of that, some regions are only offering bonuses up to $7,000.  Where you are willing to work can be financially beneficial.

Student Loan Forgiveness

An increasingly popular bonus being offered to new physicians is student loan forgiveness in return for a commitment to a contractual length of stay in the position. Once, a mainstay of rural and community health recruiting, the fierce competition for physician’s services have made student loan forgiveness a major attraction in the recruitment process.

Malpractice/Liability insurance

Insurance to protect physicians against malpractice claims is the most frequently provided benefit. This is another benefit that you should have your lawyer review to ensure that you understand coverage limits, statutes of limitations upon your leaving the position, and other details.

Relocation Stipend

Another popular benefit to consider is the relocation benefit.  Relocation stipends can generally be negotiated depending on the geographic area and individual circumstances. In these cases, it is important to fully understand what the requirements are to earn the stipend and how it will be paid out.

Retention Bonus

Because of the rising costs associated with physician vacancies and recruitment, retention bonuses are becoming a popular addition to the physician compensation package.  This bonus can be paid incrementally throughout the length of the employment contract or in some cases upon completion of the contract.

Other bonuses and stipends can be available but are less common.  In some geographic locations, physicians may be offered with a vehicle stipend, housing allowance, parking stipends, and more depending on specific challenges that one might find in a certain area.  These aren’t as common as some other incentives you can find, but if you are working with a good recruiter, they can alert you to many of the available perks.

To learn more about physician compensation or to work with a career partner who can assist you in finding the right opportunity to match your skills and career goals, contact Jackson Physician Search today.

Physician Career on Fire

Is Your Physician Career on FIRE?

Not in the literal sense, but many physicians today are working to ensure that their career is on FIRE.  FIRE as in Financial Independence, Retire Early!

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Is Your Physician Career on FIRE?

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Not in the literal sense, but many physicians today are working to ensure that their career is on FIRE.  FIRE as in Financial Independence, Retire Early!  The acronym stands for something that many of us want to achieve, but so few are able.  Physicians are in a high demand, high salary field and have that opportunity if their sights are set in that direction.  Let’s take a look at things to consider while getting your career on track for FIRE.

For starters, to learn more directly about other physicians who are working toward FIRE, consider joining almost 10,000 of your fellow MD’s and DO’s who have joined the Physicians on FIRE Facebook page here.

It’s Not All About What You Earn

Sure, salary is a large component of your ability to gain enough financial control for FIRE, but it is equally about how much you spend.  It’s never too late to make the necessary changes in your career or in your personal life to regain that control. If you’ve become complacent where you are at, you may be missing out on other opportunities that will improve your earnings power.  Still saddled with student loan debt? You are not alone.  More than 60% of medical students graduate with over $150,000 in debt. It’s time to find an employer who is willing to help out with that.  What about credit card debt?  Make a plan to consolidate it and get out from under it.  Purposeful spending doesn’t mean you have to give up your lifestyle.  It does mean, you have to decide on what is most important and what can be put aside until later.

But I Like What I Do  

The beauty of setting yourself up for early retirement and financial independence is that you are creating your own terms. If you truly want to create financial independence for yourself and family, then working toward that goal is merely “setting the table” for you to make a decision when the time is right. According to a 2016 survey, 47% of physicians indicated that they planned to retire earlier than expected.  There is a very good chance that when the time comes, and you are financially independent, you will begin thinking about other things that feed your sense of fulfillment. When you have reached FI, no one is going to force you out of practicing medicine, in fact with the continuing doctor shortage, just the opposite will occur, but you will be in the position to practice just how you like.

Practice How You Want

Being a practicing physician has been your focus for the majority of your life. Naturally, it can be disconcerting to think about what comes after you stop seeing patients.  Truthfully, that is more of a personal retirement question, than a FIRE scenario.  The end goal of FIRE is for you to be free to do what you are really passionate about. If you still want to practice medicine, you’ll be free to do it on your own terms. You might want to transition into teaching or research, and FIRE will allow you to do so without worrying about how that will affect your lifestyle.

Making a commitment to financial independence is within your control.  The idea is to reach that point of independence before you begin thinking about life after the practice.  Maybe your work and life experiences have created the itch to pen the next great American novel, or you can’t stop thinking about spending all of your time between the beach and the golf course.  Whatever it is, you have earned it.  By making financial decisions now, your FIRE can be stoked when the right time arrives.

If you want to explore physician career opportunities that can help you achieve financial and personal goals, contact a Jackson Physician Search recruitment professional today.

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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.

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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.

What You Should Know About Physician Compensation

What You Should Know About Physician Compensation

Different physician employment models can have a significant impact on how a physician is compensated. If you’re like the 69% of physicians that are…

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RVUs and the Future of Physician Compensation Models

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…

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Balancing Compensation and Culture for the Right Fit

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Balancing Compensation and Culture for the Right Fit takes a look at compensation trends, quality of practice, quality of life, practice location, and how they contribute to culture and fit.

Balancing Compensation and Culture for the Right Fit

Finding the Right Fit

Comp – Quality of Practice – Location – Quality of Life

MGMA Data – Most Used Benchmarks

  • Compensation: Total compensation reported on the W2
  • Work RVUs: Reflect the relative time and intensity associated with furnishing a Medicare PFS service
  • Compensation to Work RVU Ration: Total compensation divided by the Work RVUs

Key Trends in the 2018 MGMA Provider Compensation Data

Primary care physicians’ compensation rose by more than 10% of the past five years. Evidence of the worsening primary care physician shortage in the American healthcare system.

Depending on medical specialty, the difference in physician compensation between the highest-paid state and the lowest-paid state ranges between $100,000 and nearly $270,000.

Over the past five years, overall nonphysician provider compensation has increased at a rate of 8%. Looking at the changes over the past 10 years, the rate has doubled to 17%.

Successfully Benchmarking Compensation

Filter the data to get the most relevant data to compare again.

Ensure you are looking at the correct group of physicians

 

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How to Use Social Media for Physician Recruitment

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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.

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Rev Up Physician Recruiting with the Right Benefits, Incentives, and Perks

Whether you are recruiting physicians to a metropolitan area, where they can choose among plenty of practice opportunities, or to an underserved area, it’s important…

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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.

RVUs

RVUs and the Future of Physician Compensation Models

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…

2018 Physician Compensation Surveys

Read Between the Lines to Understand the 2018 Physician Compensation Surveys

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…

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