Tip of the week: Find a balance between compensation and productivity

Although it is tempting to base a hospitalist’s compensation on productivity, doing so can jeopardize patient safety because the physician is tempted to focus on quantity, not quality.

Another shortfall of basing too much of a physician's compensation on productivity is that the hospital may find it more difficult to recruit new hospitalists. If the productivity expectations are too high, physicians may be reluctant to join the staff because they are afraid that they will have to compromise lifestyle, says Mathews. "It is hard for places to recruit if the recruit comes in and sees that physicians are killing themselves even though they are making tons of money because that is not the mind-set of most young physicians today."

Instead, another option is to provide hospitalists with a solid base salary with the option to convert to a bonus plan that is more productivity based. Physicians who wish to stick with that base salary are welcome to do so-they are not obligated to participate in the productivity plan. Each month, however, the hospital shows the hospitalists how much they could have made under each plan, and they have the option of switching to the productivity plan at any time. Both plans should have a quality component.

"The physicians have the comfort of knowing that their base salary won't fall below a certain amount, but under this plan, I am working harder and I see that my income would have been Y instead of X, so maybe I'll make that leap," says Mathews.

This week’s tip is from Medical Staff Briefings, HCPro’s medical staff monthly newsletter. To read similar tips and articles, visit