Before discussing compensation, I suggest you make sure your supervisor is well-informed of your hospitalists’ roles and responsibilities. Discussions will be more productive if your supervisor understands the value of your hospitalists. Be careful because how you go about informing your supervisor will influence the response you get.
It’s important for your supervisor to know the hospitalist marketplace is highly competitive. There are more jobs than hospitalists. Many hospitals are developing hospitalist programs, and existing programs continue to expand. There are many signs of this competition for hospitalists. For example, I counted 130 vendors exhibiting at this year’s SHM Annual Meeting. About two-thirds are vendors recruiting hospitalists. This suggests hospitalists are in higher demand then ever. I didn’t need to come to San Diego to figure this out. One glance at the numerous ads in the pages preceding this section of The Hospitalist is sufficient evidence. Another sign of the times is the rise in hospitalist compensation since the results of the last survey two years ago.
Try to present this information to your supervisor in a nonconfrontational manner. Discussions will start poorly if this information is viewed as a threat the hospitalists will depart the program if you do not get your way. You alluded to “high turnover” in your group. Let your supervisor know you are presenting this information because you are concerned the cost of replacing hospitalists may exceed the cost of retaining experienced staff. Before discussions, I also suggest you think about why hospitalists have left your program. Your comments about increased discharges suggest a mismatch between compensation and job description. It is possible the discussion should be about changing the job description rather than adjusting compensation.
Once discussions begin, your supervisor will consider several factors when entertaining your request for additional compensation. Aside from individual performance, your supervisor will consider how your groups’ compensation compares to other hospitalists with similar job descriptions in the same geographic region. This is where the survey data are helpful. Most hospitalist compensation contains some element of incentive compensation. Do your best to compare apples to apples by looking at the entire compensation package, including benefits.
Your supervisor also will ask you to compare your groups’ job description to others in the area. Your hospitalists have tripled the number of discharges they did in 2005. Did other groups in the area see the same rise in productivity? What happened to their staffing and compensation? Expect these types of questions from your supervisor.
After your preparation, you may find that your hospitalists are being paid more, less, or about the same as what others are being paid for a comparable level of productivity. The latest SHM survey will assist you in preparing for your discussion. But please remember the survey just reports data. It does not indicate how much SHM thinks you should be working or how much money you should be making. It is merely a snapshot of what the market bears for hospitalists in our country. TH