Regarding compensation as a new attending, is base salary + RVUs or solely 100% productivity better at the 3 year (non-guaranteed) mark?

[Please_Stand_By]

For outpatient only. With simple math, say:

Company 1:
- Guaranteed salary of 100k + bonus incentives for 2 years
- At year 3: 80% of initial guaranteed + RVUs (~90+% of physicians meet minimum RVUs)

compared to another company offering:

- Guaranteed salary of 125k + bonus incentives for 2 years
- At year 3: 100% productivity

Is one generally preferred over the other? Company 2 may offer a higher guaranteed, but raises sustainability concerns. Thank you

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[dozitgetchahi]

Answer: “it depends”…on a number of variables:

- What is the specialty
- Is there good anticipated referral volume available
- What is the RVU threshold, $/wRVU, etc
- What is the average salary of physicians in your specialty in that region

Etc etc.

 

[hotsaws]

For me, base was far less important than ceiling. I've always wanted an eat what you kill type of set up. The poster above brought up some great points. The others I would mention is what kind of worker are you? Know thyself. If you're slow and conservative, like to spend a lot of time with patients, feel strongly about not ordering excessive tests/treatments, etc. then maybe a high base salary with limited ceiling is better. If you like to hustle and are looking for more of an eat what you kill set up, then productivity based is always the best. But you need to make sure and clarify what "productivity" and "RVUs" mean for compensation.

Productivity is typically collections minus overhead. The devil is in the details of how overhead is calculated, especially in a larger practice or a multi specialty practice. If you're in a group that employs midlevels, you should ask how they play into the compensation.

RVU based compensation can be defined variably. It can be a fixed amount per wRVU that you bill for. This is usually based on payor mix and the efficiency with which the group tends to collect. If this is the case, you can try and estimate your compensation based on patient volume if you wanna see what your ceiling looks like (eg. average RVUs per week based on number of patients and typical billing codes x $/RVU x weeks worked per year). Sometimes they use RVUs in an entirely different manner. A local EM group uses them to sort of partition the bonus money for the group in a given month. They take the total money collected in a timer period, subtract overhead, divide the remaining based on each person's percentage of the total RVUs. So if you had 10 docs but you billed 20% of the total RVUs, you would take 20% of that profit. I'm sure there's a dozen other convoluted ways to utilize them.

 

[hotsaws]

also, what is your specialty?