Employee Physicians: Asking for a Power Raise & Avoiding Burnout

How docs who work as employees can love their jobs

In this edition of “The Wired Practice,” Ron Harman King of Vanguard Communications explains that fiscal and physical compensation – that is, overall well-being at work – are the keys to satisfaction for doctors who work as employees.
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Video transcript

If you’re a physician who doesn’t own his own practice or isn’t a shareholder in one, you’re in the majority. According to the consulting firm Accenture, only about 1 in 3 doctors now practice independently. That’s down from 57 percent in the year 2000.

Interestingly, the overwhelming majority of physicians who choose employment over private practice ownership – 92 percent – say they do so out of necessity. Obviously, most doctors these days feel forced to work for others, and the unfortunate consequence is that someone else decides how much they earn in salary and bonuses.

For these clinicians, I suggest looking at compensation through two lenses: the first is how to improve your FISCAL compensation, and the second is ways to increase your PHYSICAL compensation. By PHYSICAL compensation, I mean your overall well-being in terms of both physical and emotional health, since the latter often affects the former.

Recent research suggests that doctors’ working conditions may be as important as income, if not more important. Let’s not mince words: we’re talking about alarming rates of doctor burnout. In a study published in the journal Mayo Clinic Proceedings, 54 percent of physicians surveyed reported having at least one symptom of burnout in 2014, up from 45 percent just three years earlier.

How to ask for a “power raise”

These findings beg the question: Is money everything? I say that it is NOT. I say instead that employee physicians should regularly consider pursuing what I call a POWER RAISE for themselves, defined as an improvement in both FISCAL and PHYSICAL and emotional gains.

First, a few tips on asking for a monetary raise, some perhaps obvious and others not so much. Start by harvesting hard data from the internet on what employee docs in your specialty and region are earning. It won’t be hard to find. There is online data aplenty, plus a growing general physician shortage in the U.S. may bolster your case. Next draft a list of your contributions over the last year to the overall clinical and financial success of your group. Thirdly, rank your tenure among colleagues – if you’re above average in length of employment, then you’ve got proof of your loyalty, which employers covet. Fourth, if your group employs patient satisfaction surveys, mine that data for your comparative value. You might also consider any improvements in patient reviews on social media as useful. Lastly, insist on a performance review every 6 to 12 months, with you and your boss setting realistic and specific goals. This exercise should equip you and your superior with clear targets that can make compensation agreements easier to achieve.

Does your place of business have enough support to avoid physician and nurse burnout?

Now, let’s address the non-monetary side of the power raise. A significant number of studies link physician burnout and job dissatisfaction with low quality of care and patient satisfaction. Conversely, happier docs tend to experience better patient adherence to recommended medication, exercise and diets; report less suboptimal care and higher patient satisfaction; and prescribe less medicine and experience fewer medical errors. So what makes a happy doctor? In my experience as a healthcare consultant, perhaps the biggest factor is the workplace environment, particularly the degree of teamwork in a practice. Quite simply, the happiest physicians don’t feel they bear an unfair share of responsibility and expertise; don’t feel they have to do everything themselves; and believe they are surrounded by competent professionals who have their back. Furthermore, they feel management hears their voices and is open to ideas for improvement.

To this end, speak not just for yourself but for the overall efficiency and health of your group. Do you work with the right mix of nurses, medical assistants and mid-level providers who leave only the more complex clinical skills to physicians? Are there enough physician providers to allow each one regular vacations and weekends not on call? Do you have a savvy administrative staff who deftly handle patient relations and patient questions ranging from billing queries to why your schedule has been disrupted for the day? Does your practice maintain a website rich in patient education, along with an easy-to-use patient portal that reduces your time addressing basic questions? Could a newer EHR system or the addition of a medical scribe slash doctor paperwork and let physicians see more patients comfortably?

Lastly, think about trading advances in salary and bonuses for a little more time off instead. Remember, job satisfaction isn’t always about dollars and cents. You might find another job at a higher salary. But chances are, the new job will be just as stressful, only in different ways. Instead, think about asking for a power raise. Go for the soft benefits as well as the hard ones, the kind that make you think, I’m very happy I became a doctor. I love where I work and what I do for patients.