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Compensation models?
Started by bougiecric
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Let the sandbagging commence.
I hate flat rate (unless you’re paying it to me as a per diem pinch hitter, that’s fine and simple).
Flat rate encourages bad behavior, slow care, poor documenting and many other sins. It also allows an employer to cut coverage and compensation in ways that aren’t as readily apparent as other comp models.
Flat rate encourages bad behavior, slow care, poor documenting and many other sins. It also allows an employer to cut coverage and compensation in ways that aren’t as readily apparent as other comp models.
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I'm skeptical too as per the above.
What about in a scenario in which the charts are equally divided to the docs (i.e. no cherry picking). Better?
What about in a scenario in which the charts are equally divided to the docs (i.e. no cherry picking). Better?
This is the only explanation you need.
I wouldn’t be a fan. Base + RVU is the sweet spot although a debate can be had based on facilities and volumes and what percentages are best.
Bittersteel
Full Member
Usually when employers change the compensation structure, it isn't for your benefit.
Straight hourly encourages a race to the bottom with regard to productivity and flow.
I know this because the employed job I quit for my democratic group had a bunch of old foggies making 2x me on an hourly basis to see less patients.
Straight hourly encourages a race to the bottom with regard to productivity and flow.
I know this because the employed job I quit for my democratic group had a bunch of old foggies making 2x me on an hourly basis to see less patients.
straight hourly can be fine, but only if you have a highly motivated collegial group, which is basically unheard of. Would have to imagine that if they're changing the payment structure, it's not to the plebs benefit.
If the shop is truly busy, pure RVU (no need for a base) is the best option.
There is a reason socialism never works. Bringing it into the ED will have the same consequence.
Imagine a shift where you were unlucky to have 2 critical care pts, you spend an hr dealing with both pts, you walk out and your rack has 10 pts deep. The other doc has no one in his rack and going to the lounge to grab lunch. This is reality.
My first job interview had this exact set up. I asked the medical director what happens if one doc was slow, what happens to the rack. His answer was, "it is under the discretion of the triage nurse". WTH
If you want a work environment where docs hate each other, have at it.
Imagine a shift where you were unlucky to have 2 critical care pts, you spend an hr dealing with both pts, you walk out and your rack has 10 pts deep. The other doc has no one in his rack and going to the lounge to grab lunch. This is reality.
My first job interview had this exact set up. I asked the medical director what happens if one doc was slow, what happens to the rack. His answer was, "it is under the discretion of the triage nurse". WTH
If you want a work environment where docs hate each other, have at it.
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Pure hourly at a busy place sucks people will give a lot of signout not pick up patients and hold patients for hours. See whatever your group pph and do not exceed that at all. If you do see more pph then make sure to go slow on some other days.
Guarantee me a reasonable hourly rate and bonus the monsters who chase RVUs.
EM doc should base at least like 250/hr Then bonus whatever else on top.
Regardless, the employer already did the math in whatever way results in them making more. That means you making less
EM doc should base at least like 250/hr Then bonus whatever else on top.
Regardless, the employer already did the math in whatever way results in them making more. That means you making less
Well unless you are your own employer and get to choose how to split the bucket up…
And I would recommended it be MOSTLY rvu/productivity, but some base component (or overnight differential component) is reasonable.
And I would recommended it be MOSTLY rvu/productivity, but some base component (or overnight differential component) is reasonable.
Hourly
vs
Hybrid
vs
RVU
Hybrid is the most best, or least worst, of the three.
Hourly and RVU are both quite annoying to work in. Hourly only works if you assign pts to doctors. RVU you get some bad, way-overdone medicine and pt's are treated like pigs.
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Also depends on the nature of your work. Ain't no way I'm accepting anything other than an agreed upon flat rate for a locums/per diem job. Permanent gigs is a different story.
Like everything else, this depends. Im RVU based, our site is RVU based and we are typically top of our whole health system.
Hybrid either has enough set to the RVU to make it matter or it doesnt and depending on that skew it will drive people to behave as an hourly doc or RVU doc.
