doctor pay cut?

Has anyone's DH/DW experienced a pay cut? It will be happening to all of the doctors, including DH, employed by his employer. It's a primary care group of family practice, peds, IM, med-peds. It's bad enough that primary care is at the low end of doctor salaries. Apparently, they used to get a percentage of all vaccinations they give. According to his employer, that's illegal and now the MDs don't get paid for any vaccinations. The salaries are production-based. Some of the MDs, mostly the peds or those with a high peds practice, may experience a 10K+ salary cut. One of DH's partners thinks her pay cut is close to 20K. DH is really bummed. I'm annoyed.

[samssugarmomma]

Ouch!

Sorry to hear it. I write here with absolutely no experience (but of course you'd know that by my signature). But I'm curious, do all the docs have lots of information available to them about their own production? If so, it shouldn't come out of the blue. But it sounds like this is out of the blue and seemingly across the board.

If it's across the board, then it's fair to ask why (if it's truly production-based) would everyone be facing a decrease? It's not likely that everyone's production is dropping at the same time. And, if everyone's production is not dropping, but everyone's salary is...then some doctors in the practice are in effect subsidizing other docs. And then the question is how long do some docs subsidize the pay of others (even if all salaries or dropping some (in theory) should be dropping more than others -- and if that's not happening than somebody's decrease is being mitigated.

Now, they may indeed have set up the system for the short-term as it were subsidies of others - sort of a profit-sharing model so that salaries aren't vacillating wildly (and they share the risks of partnership) in the short-term. But I'd want to make sure that was what was indeed happening...not an elaborate shell game.

For instance, perhaps the peds docs can't get a direct percentage of their vaccination costs. Okay that's a change but if the entire practice is now getting "more" because the rate of vaccinations stays the same and the charges also constant then where is the money (the percentage not going directly back to those administering the vaccinations going)? Are other non-vaccination providers in the practice being subsidized by that or is management getting a larger take in that example while reducing everyone's salary?

Purely hypothetical, but let's say that all doctors pay into to office overhead - lights, machines, etc. Just isolating the vaccination issue (but I'm sure it's more complicated than that) i.e. peds docs can't get a direct draw from the profit. Fine, but the "pay in" for the overhead could be reduced for each peds doc...and doncha know the reduction of that pay in could happen to be reduced by the same amount that would've in the old system equalled their draw from the vaccination monies (unless those monies are simply going elsewhere -- to other docs / the mgt / or both).

[PrincessFiona]

The practice here went to an RVU based system roughly 2? years ago. The result was that some practitioners did see a cut in pay. For some of the docs, it was substantial. Some of them have gone into retirement and others have accepted that they earn less....still others picked up more patients etc and are back to "normal"......There are a few docs though that saw their salaries rise substantially....


Kris

[peggyfromwastate]

My dad got paycuts in EM all the time, so he switched specialties to Occupational Med, where he has been more lucrative than any other form of med he practiced. Peds/family practice docs get the shaft in civilian medicine. Maybe you should all sign up for the military!

DH is a slow, meticulous type. So, yes, that's disturbing.

or is management getting a larger take in that example while reducing everyone's salary?

I think that's correct. Bottom line is the employer wants to lower all the MD's salary and they found a way to. Now, why they all of a sudden realized that the percentage thing is illegal is a mystery. It's not like his employer just formed yesterday. You'd think that a major healthcare corp would research this kind of stuff.

[Phoebe]

The hospital-based salary here based isn't on production, but they supposedly make the most revenue for the hospital and do subsidize other specialities. However, they aren't compensated like the revenue suggests. When production is less, they are definitely notified and almost penalized for it which I can't see how individuals can get out and get patients in DH's speciality.

There has been a slash in the bonus percentage written into the contract which has resulted in a pay over recent years. If it were a private group the bonus would be astronomically higher.

Now, why they all of a sudden realized that the percentage thing is illegal is a mystery.

That's terrible that it seems like management on the take. Like I said above, even if this percentage draw thing is now illegal, management could offset that change by making the pediatricians pay in less to a shared group expense like overhead costs.