Compensation in Times of Change KEEPING UP WITH CHANGES IN PHYSICIAN PAY If you think the practice of medicine has been changing fast, that’s nothing compared to changes in compensation for the practice of medicine. It used to be, in the not-so-distant past, that physicians would receive a contract outlining an offer with such things as how much call they would take, their allotted vacation time and, yes, their salary. Negotiating, if the doctor chose to do it, was largely a matter of trying to improve the numbers on the contract.
Compensation models are changing The basics of this process haven’t changed—there’s still a contract, an offer, and items such as vacation and call to review before negotiating or signing. But salary? According to Melissa Yu, MD, FAAN, that model of compensation may no longer dominate. As vice chair of the American Academy of Neurology subcommittee that oversees that group (the Practice Management and Technology Subcommittee) she has seen a wide variance in pay models other than just strict salary. To be sure, some of the variations in compensation methodology Yu experienced were tied to changes she initiated. For example, when Yu moved to academia after eight years in private practice, (she’s now an associate professor in Baylor College of Medicine’s
Department of Neurology), she naturally entered into a different payment model for her work. Before making that switch in 2012, her compensation was frequently affected by adjustments in how Medicare payments were made. But even in the traditionally stable academic sector, Yu has seen changes. Indeed, her added administrative responsibilities have exposed her to the compensation planning process at her institution. Yu’s conclusion from all of these experiences, direct and indirect? “The age of the guaranteed, straight salary is decreasing,” she says. Replacing it? “We’re seeing more ties to metrics. Whether it’s clinical productivity, quality measures or patient satisfaction, physicians in general are just being measured more.” In short, if you’re not already experiencing this, you can expect at least some of your compensation in the future to be tied to your performance metrics.
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