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Salary Negotiations & Compensation for Doctors

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Physicians once went into private practice or joined a group of other doctors, but in the modern health care environment, with increasing regulations and shrinking reimbursement, it is much more common for physicians to become employees of a large medical group or a hospital, according to the Texas Medical Association (TMA). Employed physicians must engage in salary negotiations, which can affect their salaries.

What Affects Salary

Physicians’ compensation can vary based on specialty, gender, geographic region and employer, according to “Becker’s Hospital Review.” In anesthesiology, for example, base salary offers in 2011 ranged from $290,000 to $475,000 per year. Hospital-employed anesthesiologists earned $325,000. The mean salary for women was $260,000 and for men, $324,000. Base salary offers for internists ranged from $130,000 to $285,000 and for orthopedic surgeons, from $300,000 to $700,000. Female internists earned $149,000 in 2011, and men made $175,000. The Northeast was the lowest-paying region for internists and orthopedic surgeons, while the West was the lowest-paying region for anesthesiologists.

Salary Versus Compensation

Doctors’ compensation might take the form of a fixed salary, an arrangement in which they are compensated for productivity, or a combination of the two. Some physicians are also eligible for bonuses if they meet quality or other targets. Many factors affect the ultimate compensation, so a physician must understand the various components of salary plans. For example, compensation might be based on a percentage of collections, so the physician should ensure patients are fairly assigned when negotiating the employment agreement, according to the TMA.

Supervision Means Extra Work

Physicians often supervise other health care professionals, such as nurse practitioners and physician assistants. The time for supervision is carved out of the time the doctor has to see patients -- visits for which he can bill. Since he is providing a service to the organization by supervising others, which means the organization can bill for more patients, the physician should ensure he is compensated for the extra work. Prior to engaging in salary negotiations, the TMA recommends physicians review research and surveys to determine what is fair for both employee and employer.

Issues for Women

Female physicians often earn less than their peers, according to a July 2012 article in the “Journal of the American Medical Association.” The salary difference could be significant -- as much as $13,000 a year -- even when both men and women entered the same specialty. In a July 2012 article in “U.S. News Education,” the article’s authors recommended women negotiate based on performance, research potential employers carefully to determine what other physicians are getting, practice to strengthen negotiation techniques, and showcase their awards or other indicators of good performance.