Page 28 - Delaware Medical Journal - February 2017
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Employers typically pay physicians based on one of three models: straight salary (with or without bonus opportunities), 
• Straight salary. The straight salary   time. No matter how hard you work, how many patient you see, or how many procedures you perform, your salary remains the same.
• Productivity. Under this model, you are paid according to your personal productivity. This may be measured as cash in the door, work relative value unites (WRVUs), patient encounters, number of call shifts, overnight shifts, or another standard. This model often includes a lower base salary or draw, but the more productive you are, the more money you can make.
The WRVU measurement eliminates bias based on the payer mix of a physician’s patients. For instance, a physician who treats only uninsured patients likely generates far less cash in the door than a physician who treats only privately insured patients. But if they work the same number of hours and see the same number of patients, they should have the same number of WRVUs.
• Profit-Centered. model bases your salary on both your productivity and your expenses. Your compensation depends on both the opportunities you have to generate revenue and your ability to keep expenses to a minimum.
If you’re considering an opportunity with this payment model, it is important to understand the approximate revenue you can generate and how expenses are
calculated. Are expenses determined
  each responsible for 20 percent of the expenses), or are they based on some other formula?
For some employers, the compensation model may be negotiable. If you’re more comfortable with one model over another, it’s worth asking your potential  response will likely depend on the size of the practice and how developed its infrastructure is. Other employers may start you with a straight salary that shifts to a productivity model at some predetermined point in time.
To Help You Evaluate
Diane Godorov, DO is a pediatrician who has worked in several different settings including private practice and urgent care. “It is important to know what you are supposed to earn and how realistic it is that you can attain proposed bonuses,” she says. “Having an objective, unbiased resource to help you set compensation expectations is very important.”
One source of objective data is the Medical Group Management Association (MGMA), which publishes several reports compiling annual compensation data
for physicians. MGMA data shows how salaries are affected by factors such as specialty, years of experience, size of practice, and geographic location and
can help you understand the physician marketplace.
For physicians pursuing academic medicine, the Association of American Medical Colleges (AAMC) publishes physician compensation data. AAMC reports
include detailed information about how compensation is affected by faculty level, departments and specialties, and the mix of clinical work, teaching, and research.
Many employers use national surveys such as the above to set salary bonus
caps at the median or 75th percentile.
By creating this cap, an employer can ensure that compensation is based on fair market value and balanced among peers.  ease your anxiety of switching from a job with a guaranteed salary to one that may be variable and based on factors outside of your control.
Another compensation factor to be aware of is that, if your practice includes clinical or academic research, your employer may expect you to secure grant dollars to cover part of your own compensation. If the grant dollars are eliminated or reduced, your compensation may be adjusted accordingly. In many instances, receiving additional grants may not increase your compensation, but it can allow additional research to be performed by hiring additional staff.
Weigh It: Benefits

of the compensation package, but they

dollars and in quality of life.
For Kirschner, “maternity leave was an important consideration of any job offer.” As a pediatrician and a hopeful mother,  job search.
It’s important to understand how the

monetarily and toward your quality
of life. What is the value of the health insurance and vacation time offered or the funds available for CME? How about the value of the retirement program or the professional insurance coverage offered?
An opportunity with a lower base salary
Del Med J | February 2017 | Vol. 89 | No. 2

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