bobuddy Posted January 22, 2011 Share Posted January 22, 2011 Hi everyone, I am hoping for some advice from all of you regarding upcoming changes to our clinic. I currently work in a Family Practice (somewhat) rural KY clinic as the only mid-level with three other MD's. I have been there for almost 10 years and am relatively happy except for the salary (which is on the low side). The MD that started the clinic 40 years ago and has been the decision maker for the practice (although the other two are considered partners) is now retiring. I have been considering approaching the other MD's with the possibility of being more involved in the practice - and possibly changing how I am paid. Currently I am salaried - take no call, no holidays or weekends. If I see 10 patients or 30 - my salary is the same. There is very little in the way of raises or bonuses - which is a sticking point for me, but I know if I leave the clinic I would have to drive to a larger city to find another job (45 min commute each way - but currently I am 10 minutes from the clinic). With the founder of the practice leaving in a few months, I have considered changing from a salaried position to a productivity position (I dont know if this is possible) but I am not sure what to even ask for. Also - for those that are more involved with the day to day runnings of the office - what do you like about it - or do you wish you could just see patients and collect your check and go home? One concern I have - is that in our smallish rural area - there have been moderate job losses. Many more people without insurance and those with insurance have much higher deductibles and co-pays - meaning we have seen a significant reduction in patients coming in over the past few years. There are many days where I am seeing 10-15 patients a day - along with the docs. But, with the main doc retiring - maybe I will be seeing 30 patients a day - hard to tell right now. Have any of you wished you were salary instead of productivity - or vice versa? How do you figure a salary and bonus structure with our economy these days and reimbursement going down? Thanks in advance Laurie Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 23, 2011 Moderator Share Posted January 23, 2011 I work base salary + production now and honestly would prefer straight(higher ) salary. I think production bonuses encourage people to be sloppy and document poorly just to see more pts. some of my colleagues write charts that after the fact are not decipherable just to breeze through and grab the next chart... Link to comment Share on other sites More sharing options...
aprillh Posted January 25, 2011 Share Posted January 25, 2011 I have the opposite view of Emed here. I have worked as a salaried PA, salary + bonus, and straight percentage compensation. My strong preference is straight percentage. It is motivating for the PA as well as the practice, since the more I make, the more the practice makes. I can see Emed's point too, in the wrong hands, percentage compensation could turn ugly. But most PAs I know that are paid a percentage of collections aren't just gunning for more cash. Their main priority is taking good care of their patients, which they do well. Since you mentioned the economy wasn't thriving in your area, maybe you could change your pay structure to salary + bonus. At least that way you have something to fall back on and if you make your bonus, it is just that. A bonus. Have you thought about becoming part owner of the practice? I don't know what your relationship is like with the two remaining docs, but they may be very open to having another partner to share-the-wealth so to speak. Share the headaches too of course, but it could be a great deal. Link to comment Share on other sites More sharing options...
v_chicky Posted January 25, 2011 Share Posted January 25, 2011 i'm on salary + bonus and it was great until we hired 7 more providers. since then, with the economy in the tank, health insurance losses, state health cuts, etc, our numbers have falled substantially. since this doesn't affect my salary, i wasn't very concerned until i started being penalized for not making a bonus. i am now getting my CV and such together to search for a new job. if i were you, i'd either ask for the salary + bonus, with a stipulation mentioned by jmj of this board - "there will be no undue/external influences enforced that limit by ability to meet my base RVU requirement" OR just stick with salary if you're only seeing 10-15 patients per day. Link to comment Share on other sites More sharing options...
bobuddy Posted January 26, 2011 Author Share Posted January 26, 2011 Is there anyone out there that is part owner of their practice? I agree with the salary + bonus part - but you guys are right - as long as there is no obstruction to me seeing patients. I know that currently in the practice - I am seeing the overflow, but I also have my own patients that just see me. I know in the past that the main doc (that will be retiring) made it known that the docs schedules are to be filled first, then mine. I am hoping with his departure, I will be more of an equal player in this practice - possibly even part owner, but I am not exactly sure what the means - all the gritty details. jmj- if you are out there - I know you are running your own clinic. Care to share any details of what that means to you? Link to comment Share on other sites More sharing options...
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