Contract Renegotiation

[CaliDr]

As always, this helpful community has answered many of my questions over the years. Again I'm calling on all of you senior pain providers to See if you can assist and provide some guidance. I'm sure this topic will also be useful to others as well.

So I currently serve as medical director of our pain clinic as the sole pain provider in a rural health setting. My salary is definitely on the higher end So I'm not sure there's much wiggle room on that contract. I also have managed to adjust my in person clinic time to 3 days a week when the contract actually states four. I meet and exceed my RVUs with this crane arrangement so they have not given me any issues with this... However, I also have a separate medical director contract for our wellness clinic which I've helped build from the ground up which now includes five or six different tracks (diabetes, pain, chf, obesity, etc). this is my first and only job (9years in) but I'm currently one of the senior staffers within the hospital system. I've also served as chief of staff.

Because my pain contract is on the higher end, I am expecting a lot of pushback If I ask for an increase there, but my medical director roll I think could increase salary wise. I have not asked for a raise in over 3 years and I'm just looking for some feedback on how to best navigate a request for salary increase based on some of your previous experiences. every time my contract renewal comes up I always want to ask for more but I'm scared that since I'm already on the hiring they will revisit The totality of my contracts and try and do the opposite of what was intended. I'm just doing a ton more work with the wellness medical director roll while so meeting and exceeding my pain benchmarks. Any other part that's important is im part of a large medical group that provide services for a hospital.

---

Members don't see this ad.

 

[Ligament]

First thing I'd suggest is calling us and yourself a physician, not a provider. I certainly do not provide anything. I sell my professional services for money. A parent provides for free to his kids. When you use the term provider, you empower those who think you should work for free.

 

[drusso]

As always, this helpful community has answered many of my questions over the years. Again I'm calling on all of you senior pain providers to See if you can assist and provide some guidance. I'm sure this topic will also be useful to others as well.

So I currently serve as medical director of our pain clinic as the sole pain provider in a rural health setting. My salary is definitely on the higher end So I'm not sure there's much wiggle room on that contract. I also have managed to adjust my in person clinic time to 3 days a week when the contract actually states four. I meet and exceed my RVUs with this crane arrangement so they have not given me any issues with this... However, I also have a separate medical director contract for our wellness clinic which I've helped build from the ground up which now includes five or six different tracks (diabetes, pain, chf, obesity, etc). this is my first and only job (9years in) but I'm currently one of the senior staffers within the hospital system. I've also served as chief of staff.

Because my pain contract is on the higher end, I am expecting a lot of pushback If I ask for an increase there, but my medical director roll I think could increase salary wise. I have not asked for a raise in over 3 years and I'm just looking for some feedback on how to best navigate a request for salary increase based on some of your previous experiences. every time my contract renewal comes up I always want to ask for more but I'm scared that since I'm already on the hiring they will revisit The totality of my contracts and try and do the opposite of what was intended. I'm just doing a ton more work with the wellness medical director roll while so meeting and exceeding my pain benchmarks. Any other part that's important is im part of a large medical group that provide services for a hospital.

It's important to get the discussion in the right "frame" from the get go: You're not a wage worker asking for a raise. You're asking them to SHARE value YOU create for THEM. You're a MAKER/CREATOR/CONJURER of VALUE. It's only natural/human/dignified to share value with people you trust. Do they trust you? Do they trust you'll deliver? If the answer is, "yes, Doctor we value and trust you," then "Show me."

So, first: What's your enterprise value to them? How much are you bringing to the table in direct service, ancillaries, rain-making etc. Some analyses suggest that your value could be as high or higher than $2 million dollars. Do THEY value your contribution?

Employed Physicians Create Almost $2.4M a Year in Hospital Revenue | TechTarget

A new report shows employed physicians are a major driver of hospital revenue, with specialists and primary care doctors generating $2.5 million and $2.1 million a year, respectively.

revcycleintelligence.com

Now, second: Given, that you've established the size of the pie, it's time to discuss how to share it. Lot's of ways to creatively share value: Salary, paid time off, directorship stipends, bonus, retirement, CME, technology stipends, etc. This is where it become a barter/TV show...Price is Right?

If you get prematurely boxed or anchored into a "zero sum" / fixed pie mentality you're going to leave money on the table. I'd go into the discussion with a "growth mindset" and creative problem solving mentality to fix a very serious problem: An Inequity in how the parties are sharing value you create.

 

[Piebaldi]

First thing I'd suggest is calling us and yourself a physician, not a provider. I certainly do not provide anything. I sell my professional services for money. A parent provides for free to his kids. When you use the term provider, you empower those who think you should work for free.

Lol I think this is a great post. I need to get this attitude!

 

[CaliDr]

Excellent physician perspective @drusso ! As always, very thoughtful feedback. After I wrote the original post, I ended up at a similar conclusion about creative ideas to offer instead of straight compensation to the physician salary. I went ahead with a starting the conversation off with additional student loan payment through the hospital versus physician salary through the medical group. Since my physician directorship is directly contracted to the hospital versus the salaried pain management physician position with medical group, this seems to be a pretty good starting point for a physician.