As of January 2013, approximately 25 percent of all specialty physicians were employed by hospitals, according to Becker’s Hospital Review. For primary care physicians, the number was closer to 40 percent. Reimbursement issues and other problems related to private practice lead to increasing numbers of physicians signing on with hospitals as employees. One major difference in the new role, however, is the need to negotiate salaries.
When Demand is High
Some physician specialties are in such high demand, physicians may find negotiating relatively easy. Family practice physicians have been in high demand for several years, resulting in a 6 percent increase in salaries for these specialists between 2011 and 2012, according to a July 2012 article on the American Academy of Family Physicians website. Reimbursement for family practitioners, however, is not as high as that for most surgical specialties, which may be able to command much higher starting salaries. Orthopedic surgeons, for example, had a starting salary range of $300,000 to $700,000 in 2011, according to Becker’s Hospital Review.
Thorough preparation is one key to salary negotiations, according to an August 2011 article in HealthECareers. Begin with researching the job, the going rate for the specialty in that locality and nationwide, opportunities for advancement, and the size and business model of the organization. A large hospital system that is heavily bureaucratic may offer less flexibility in the negotiating process than a smaller, independent hospital, even if the initial salary offer isn’t as high. On the other hand, a hospital with multiple sites may offer more opportunities in the long run.
Identify the factors you feel are important. Decide if you will trade flexibility of work schedule or better benefits for a lower salary, for example. Identify deal breakers and points on which you are unwilling to compromise. Be prepared to discuss many issues to get what you want. These might include a sign-on bonus, benefits, practice restrictions, vacation, productivity, the call schedule, the length of the contract and whether you will have administrative, research or teaching duties as well as clinical responsibilities, according to HealthECareers.
New vs. Experienced Physicians
Physicians who are just starting out may have different issues than those who have practiced for some time. A new physician might negotiate for student loan repayments in place of a higher salary, for example. More experienced physicians who have established a practice and demonstrated that they can improve the hospital’s bottom line through reimbursements for admissions, surgeries or procedures, might want to focus on productivity increases or bonuses. Bonuses could be based on patient visits, gross billing or gross collections, for example, according to a fall 2011 article in Practice Link. If you are a hospital-employed physician, you must be knowledgeable and assertive to obtain what's best for you.