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Prescription for medical compensation

Compensation is an important component of working at a hospital, health care system or a physician group. Negotiating employment contracts for medical professionals needs to address several compensation considerations.

Compensation should be comparable to other medical professionals with similar skills and experience in the locality. Survey reports on compensation and speaking with colleagues can help provide important information. The base salary should be guaranteed as long as possible without adjustment. This may be one year for practitioners just coming out of training. Doctors joining a health care system that is part of a practice may be able to negotiate a longer time, such as three to five years.

Productivity, quality, cost and other metrics may also play a role in determining compensation. These should be included in the agreement or a written policy. Metrics should not be discretionary and need to apply to all similarly-placed practitioners. The benchmarks must be clearly defined. It is also important to understand how data will be obtained and submitted and whether a practitioner's time off impacts how productivity is calculated.

If incentive payments are made in additional to base compensation, a practitioner should review how they qualify and what the calculation methods are. Some are still based on collections or work-relative value units, while value-based payment models are being used more.

Benefits are an important component as well. Hospital and health care systems usually offer a better package of benefits and retirement options than private practice. Typical benefits include health insurance for practitioners and possibly for their families, license fees, medical staff dues, continuing education reimbursement, malpractice insurance and three to four weeks off for vacation, sick and continuing medical education time. Other benefits may include a retirement plan, moving expense allowance, forgiveness for educational loans and paid sick leave.

Occurrence-based malpractice insurance, which covers claims that happen during the coverage year regardless of when it is made, is preferable. Paid time off should be clearly set forth or changes could lower compensation.

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