Eat what you kill vs Hourly/Salary

[GaseousClay]

Wondering what most of your guys' jobs pay structure is like. Are most of you private guys in a eat-what-you-kill model based on units? Those on salary or hourly (i.e. big AMCs, kaiser system, etc) what is your work like? Im sure a lot of you guys have done both models what do you prefer? I feel like eat what you kill allows you to earn more money overall but seems like its a lot of stress to be always counting units and even thinking of procedures as ways to create income rather than whats best for the patients. any thoughts?

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[IlDestriero]

My academic job has a base salary, annual bonus based on how the department as a whole did, and compensation for call and late shifts. We try to run lean and efficiently, while still getting people time for academic pursuits. My last academic job was more traditional salary with extra hourly compensation for working after 3pm when not on call.

 

[GA8314]

If we had an eat what you kill policy in our practice we'd all be clamoring for ENDO! lol That, needless to say, wouldn't exactly be professionally satisfying. Then again, if you can earn enough......

But, isn't that much of what any career boils down to? Quality of work/professional satisfaction, versus income? Finding that balance is difficult, and I'm sure it evolves throughout one's career.

 

[Man o War]

I have worked in both eat what you kill and communistic models. Eat what you kill is fine IF case choice rotates every day so everyone gets equal crack at the high generators- I know quite a few predatory private groups where the older guys poach the high RVU cases and leave the rest for the younger guys. I was actually happiest in the communistic model- we paid all our bills and the rest got divided equally quarterly. However, my group consisted of guys who all worked hard and didn't slack off or take advantage of the fact that they could be lazy if they wanted to.

 

[Stank811]

It is hard to run an efficient OR in a true eat what you kill set up. No one wants to give up cases and are willing to stack cases as opposed to open another OR and have a partner take the case etc. But with that said as Man o War stated there a lot of private practice groups with variations in which you get a salary and then bonuses based on production. I like that set up the best.

 

[GA8314]

I have worked in both eat what you kill and communistic models. Eat what you kill is fine IF case choice rotates every day so everyone gets equal crack at the high generators- I know quite a few predatory private groups where the older guys poach the high RVU cases and leave the rest for the younger guys. I was actually happiest in the communistic model- we paid all our bills and the rest got divided equally quarterly. However, my group consisted of guys who all worked hard and didn't slack off or take advantage of the fact that they could be lazy if they wanted to.

I f.cking hate
Lazy m.ther f.ckers..... Just sayin.

 

[Ezekiel2517]

Eat what you kill + stipends + bonuses

 

[chocomorsel]

Eat what you kill in a blended unit value system is the most fair way and leads to the least amount of laziness. I worked in both and in the salary model, I tended to get screwed into staying late often to finish cases and partners went home early and got paid the same.
In eat what you kill with blended units, the person who sets the schedule gives the call person the highest unit value based on the case RVU and on down the list it goes. If someone wants to give cases away, then they can, but people tend to be much more driven. I don't get screwed much.

 

[Ignatius J]

Eat what you kill in a blended unit value system is the most fair way and leads to the least amount of laziness. I worked in both and in the salary model, I tended to get screwed into staying late often to finish cases and partners went home early and got paid the same.
In eat what you kill with blended units, the person who sets the schedule gives the call person the highest unit value based on the case RVU and on down the list it goes. If someone wants to give cases away, then they can, but people tend to be much more driven. I don't get screwed much.

What we do and I love it. Much less headache covering late, early, and weekend cases.

 

[Mman]

we are communists and dole out work by hours, not RVUs. Everybody works the same amount of time and gets paid the same amount.

 

[deleted162650]

I currently work in both systems as I'm transitioning from one practice to another. Honestly I don't think it matters much provided that either system is structured fairly and that overall compensation is adequate. There are ways to game any system, and those are gamers will always do what they're gonna do. What's key is being in a system full of high quality individuals (i.e. not douchebags) all working towards a common goal which in my mind is to a) take excellent care of pts using relevant/modern techniques b) maximize revenue c) spend as little wasted time in the hospital as possible.

Blended unit eat-what-you-kill is certainly the simplest/cleanest way to run a practice. That being said, efficiency suffers as people can get possessive of "their" line-ups. It can be touchy to run a true "peel off" system. It does encourage productivity though and compensation for call takes care of itself.

Being on a salary or a point system (pm me for details) can complicate things and can encourage feet dragging, but it improves efficiency and makes running a peel easier.

Really though the players are so much more important than the game. I wouldn't choose one job over another simply because one is eat-what-you-kill and the other is more socialist. Both systems can work beautifully and both can be a disaster.

I will say though that being in a eat-what-you-kill practice really educates you on how billing works/what cases are worth/what your time can be worth/etc.