Corporate incentives make a move to medicine
But salaries shift little
More managers in academic practices are seeing bonuses and other rewards for efficiency in their pay packets, according to the Academic Practice Management Compensation Survey, published by the Medical Group Management Association in Englewood, CO. The survey reports that more than 48% of the 424 respondents reported that some kind of incentive program was in place in their facility.
This is part of a trend, says Martin Friedman, MBA, chief administrative officer of the department of medicine at Pennsylvania State University in Hershey. Friedman was on the committee that worked on the survey, as well as its sister publication, the Academic Practice Faculty Compensation and Production Survey.
"Five years ago, there were few academic institutions that cared about bonuses and incentives," he explains. "They relied on nonclinical sources of income to fund their academic mission. Now, clinical income and profitability is more important, and there has to be an incentive to cut waste and improve productivity."
For physicians, the old methods of gaining promotion, stature, and tenure were research, publication, and government grants. "Now they have to concentrate on the clinical aspects of what they do," Friedman says.
While some of the comparative data may seem surprising, Friedman says there are few real shocks in the numbers. (See charts, above right and p. 66.) For example, nonphysician clinical practice managers saw little if any increase in salary after a year. In some regions and at some experience levels, there were even small decreases in total compensation. But Friedman says that when you have numbers of less than 100 responding to a survey, any anomaly in salaries is more likely to have a skewing effect on the data.
Friedman says that physician compensation findings were largely in line with expectations. Primary care physicians are seeing larger increases in their compensation than most of the specialties. Some of the specialists, such as invasive cardiologists and rheumatologists, are noting cuts in their salaries.
"There are always targets like cardiology or dermatology which will see salaries decline as Medicare reimbursement goes down," says Friedman. "I think that those specialties where you are seeing large increases are more anomalies that will be corrected over time."
Friedman says the next five to 10 years will also correct some of the larger discrepancies between the compensation of private practitioners and those in academic practices. "As you have pressure for academic physicians to spend more time on clinical concerns and less on academic issues, they will demand more money, and that difference in compensation will shrink."
• Medical Group Management Association, Englewood, CO. Telephone: (303) 799-1111.
• Martin Friedman, MBA, chief administrative officer, Department of Medicine, Pennsylvania State University, Hershey. Telephone: (717) 531-8390.
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