Is Your Bonus Attainable or Just a Tease?

Leigh Page

Disclosures

November 17, 2016

In This Article

How to Attain the Unattainable

So what can you do to secure a bonus? Before you take a job, closely examine your employment contract, advises attorney Andrew Knoll. Try to identify a level of RVUs that's far above what you're personally expecting to work at, he says.

Dr Knoll says a hospital that quotes a stratospheric RVU threshold should be troubling to a job applicant, because it's more than just an honest mistake. "It indicates that the hospital might be a bad partner in a lot of other ways," he says. "In that case, you might consider walking away from the deal."

Although you can get the employer to change some aspects of the contract, such as the amount of the signing bonus, the bonus compensation program is usually not one of them, Dr Knoll says.

"Small organizations might agree to change the bonus formula for you, but a large hospital or practice will not budge," he says. "Keeping like groups of doctors under the very same formula is administratively much easier than allowing for exceptions."

If the bonus appears to be unattainable, you may decide to accept the job anyway because you like other aspects of it, Dr Knoll says. In that case, "budget your life on the base pay. And if it turns out you do achieve the bonus, treat it as found money."

Many physicians, however, discover that their bonus is unattainable only after they've taken the job. Mertz advises these physicians to approach the administration as a group. "Explain why the incentive is unfair," he says. A hospital that truly wants to keep its physicians happy will try to address their concerns. He says that the organization will probably hire an expert on bonus formulas to review the arrangement and see if it can be made fairer.

In many organizations, Mertz says, physicians already sit on standing committees that advise the administration on bonus models. The administration may not heed the committee's advice, however, because it also has to watch its bottom line, and more liberal bonus plans will cost more money.

Simply put, employers' own self-interest lies with bonus plans that fully motivate physicians, and that means they have to be attainable, consultant John Hill says.

Hospitals in particular need effective incentive plans more than ever, he says. "They don't have the option of spinning off employed physicians, as they did 15 years ago," Hill explains. "They need engaged physicians to meet all the mandates they have to deal with," such as lowering readmissions, fulfilling payers' reporting requirements, and building accountable care organizations.

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