Physicians are among the highest earning professionals in the world. But while years of medical school and residency arm doctors with highly specialized skills in their fields, more frequently, practitioners are seeking additional guidance to help plan their careers and navigate the changing landscape of medical practice. From new residents, laden with student loan debt and considering which specialty to pursue, to seasoned professionals pondering private practice, physicians at every level in their careers find it necessary to keep a finger on the pulse of the industry.
Physicians Are Valuable to Facilities
While shifting compensation models are a rising concern for many, a new survey confirms physicians’ pivotal role in hospitals —not only as healthcare providers, but as the financial keystones of their institutions. A recent study, released by national physician search and consulting firm Merritt Hawkins
, reported that physicians and surgeons generated $1.56 million in average annual net revenue on behalf of their affiliated hospitals in 2016.
Greater Opportunity in Larger Facilities
Where you want to work as a doctor affects your salary and negotiating power. If you choose to work in a large practice or hospital, you may have more negotiating room because of larger budgets than with a smaller practice. Compensations also vary depending on where you choose to practice. (see chart below) If you choose to work in a private practice or medical facility, there are different types of working agreements such as partnership, independent contractor and practice support that may affect the compensation. Depending on your agreement, you may receive a fixed salary, percentage of profits or collections, or pay based on how much work you complete.
There is more to compensation than just salary. If you find that a salary offer is on the low end, consider adding other perks to your negotiations. Some of the factors to consider include vacation time, call schedule, teaching schedule and responsibilities as well as contract terms. You can also ask for a signing bonus or that the employer cover the cost of your malpractice insurance. When adding these types of perks to your negotiations, work them into your counter offer.
PCPs in Highest Demand
Although Primary Care Physicians (PCP) bring in revenues of just $1.4 million as compared to specialists (at about $200,000 more), PCPs have an opportunity to be on the front lines of medicine. PCPs are the first line of defense for patients — which means that you see all the newest bugs and ailments first. PCPs are the key players in treating everything from national flu epidemics to local Lyme disease upticks to widespread food poisonings and recalls. It's a role that can be exciting and diagnostically challenging, and that is vital to the success of the healthcare system.
Primary care also offers a good opportunity for work-life balance and a lot of choice as to how, where, and how many hours to practice. There are many employment and practice models to choose from, and options for part-time schedules and fewer nights on call. Although many PCPs work hectic schedules packed with patients and paperwork, there are still more options for flexibility and balance than in many specialties.
In fact, the Academy of Family Physicians indicated that by 2020, demand for family physicians in the U.S. will exceed the supply. Though the future of the private practice model is a moving target and there may be changes in how and where care will be delivered, it's clear that with physician shortages looming, primary care offers job security for the long haul.
Conversely, physician specialists are generating the highest revenues for hospitals. As the Merritt Hawkins analysis shows, in 2016, specialist revenues increased 14% to $1.6 million, up from $1.4 million in 2013. This varies for different specialties.
On average, a doctor brings in $1.56 million in direct net inpatient and outpatient revenue to a hospital. This is an increase of nearly 8% from $1.45 million in 2013. The upward trend in revenues bodes well for all physicians across the board.
Do Your Research
Gauge how well your credentials (education, training and experience) match the needs of your potential employer (for example, patient volumes, managed care experience, prior employment in a specific type of practice setting). You should be able to ascertain this during the interview process. Your recruiter should also be able to tell you. If you have what they want, you're in a good position. You'll be in an even better position if you have a skill, interest or expertise that no one else in the practice or the immediate area has, particularly one that will attract patients or referrals. The more closely your experience matches what a potential employer needs and the more in demand your expertise is, the more leverage you've got during salary negotiations.
So, whether you are a PCP, a specialist, some private practitioner or locum tenens, exercise due diligence before going for that interview. Research the local precedent -- what others in the area or in the practice you're interviewing with are making. Understand the local, regional and national markets. You can't merely insist that you be paid more than you made in your last job or, if it's your first job, a salary comparable to what your fellow resident will be making elsewhere.
If, during your research into your new potential employers, you discover that they have a solid need for your skills set, the next step is to consider your competition. It's good to know how many other physicians have applied for the job and, if possible, who they are and their qualifications. However, this is much easier said than done. The best approach is to ask the recruiter you are working with and hope they are forthcoming.
Medicine is a business, and like all businesses, your future employer will need you to generate income and to keep it coming. If you have a patient following and no encumbrances, such as a previous non-compete agreement that would prevent you from bringing your patients to your new practice, or if you have a reputation that precedes you, you'll be in a stronger position to discuss salary, benefits, perquisites and relocation. Most newcomers don't provide incremental income to a practice, so if you are able to, you will be in a stronger negotiating position. And, if there's a need for your services and little or no competition for the position, you've got leverage. A recent study reported that physicians and surgeons generated $1.56 million in average annual net revenue on behalf of their affiliated hospitals in 2016.