Are You Earning as Much as Your Peers?

Shelly Reese


November 21, 2013

When it comes to medical practice staff salaries and job security, advanced training pays off. That's the message that physician respondents telegraphed in the Medscape Clinical & Office Staff Salary Report. Medscape surveyed US physicians, from a diverse array of specialties, about the salaries and compensation packages they offer their staff members. The survey was fielded from September 9 to October 7, 2013, and 2399 physicians responded.

When asked about their pay rates and future staffing plans, respondents showed that they're willing to pay more to clinical employees who can provide important patient care services and ultimately help improve the bottom line.

Who Makes How Much?

Clinical and nonclinical salaries differ markedly, according to physicians responding to the survey.

Front-desk personnel, a fixture in 84% of the medical practices surveyed, play a critical role in setting the tone of a patient's office visit and facilitate office efficiency by scheduling appointments, fielding calls, making reminder calls, verifying insurance, collecting copayments and, often, billing and coding. But their compensation doesn't reflect the many hats they wear. While the healthcare industry talks a lot about improving customer service and the patient experience, front-desk staffers' compensation generally doesn't reinforce that message. Nearly two thirds (64%) of physicians surveyed say they pay their front-desk staff less than $30,000 each.

"At the end of the day, the front-desk staff is viewed more as a task-oriented logistical manager," says Tommy Bohannon, Divisional Vice President of Recruiting for Merritt Hawkins, an Irving, Texas-based physician recruiting firm.

Employed by only 31% of the practices surveyed, medical records clerks earned even less, with 72% of respondents paying them less than $30,000. Medical billers, employed by 61% of the practices surveyed, were the highest paid nonclinical employees in most practices, with the majority (60%) earning between $30,000 and $60,000. The higher pay scale likely reflects the increased demand for billers that has preceded the transition to the ICD-10 coding system, which goes into effect next October.

On the clinical side, the pay hierarchy rewards staff members who deliver billable services. Nurse practitioners (NPs) and physician assistants (PAs), whose services are billable under Medicare, are the most highly compensated. More than half (55%) of the physicians surveyed say they pay their NPs more than $80,000, including 16% who pay them $100,000 or more. PAs earned even more, with 57% of those working in the surveyed practices earning more than $80,000 and 19% falling into the top category of $100,000 or more.

NP and PA salaries have both climbed steadily in recent years, reflecting their value as care providers and revenue generators, says Bohannon. Although their services are reimbursed at a lower level than a physician's, "they generate an RVU and a charge just like the doctor and they make a half or a third of the doctor's salary." In most practices, employing NPs and PAs makes enormous economic sense, he says, because it enables physicians to concentrate on areas that have the highest reimbursement. "A vascular surgeon can focus on performing surgery and let the NP or PA attend to the patients who need to be seen before and after surgery for office visits."

While NPs and PAs can stand in for the physician for some tasks, medical assistants -- the least trained and lowest-paid members of the clinical staff -- can do the same for registered nurses (RNs), generating a cost savings for the practice. More than half (55%) of respondents pay medical assistants less than $30,000. By contrast, the majority of physicians surveyed (61%) pay RNs between $30,000 and $60,000.


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