I am looking for thoughts about fair methods of compensation. I am a part-time physician in a non-procedural internal medicine subspecialty. I finished my fellowship last year and joined a large single-specialty practice (several male partners and 1 female partner). No one works part-time, except for the (female) PA. They were looking for someone full time, but we got along and they hired me. I love the practice and am happy there. They currently pay me hourly, with a stipend to take call. I am supposed to work 20 hrs/wk, but I usually work ~23. I get no bonuses for productivity, though I was in the black about 4 mo into my practice. I don't know whether I am being fairly compensated, and was wondering what arrangements others have had that worked. I don't get too frustrated when I work more hours, because I am paid for it. On the other hand, I don't really see the benefits of what I bring in. Any thoughts?

I think it's fair to be paid by the hour and per call, as long as the rate is good. If you love the practice and are happy there, then that is even better.

Contrary to current political opinion, there are many fair ways of compensating physicians: hourly, salaried, fee for service, benefits, chance to become a partner, or a combination of the above. As long as you are willing to work there, they are willing to pay you, and the patients are getting good care, it is fair.

I don't know exactly having never worked part time, but my boss has mentioned on several occasions that I could share my full time position with another woman and that way we would be only getting paid half our salary but the hospital would be getting essentially full time employees since part time is never really part time in our profession. For this reason, my friend who is also a surgeon in large HMO works per diem and takes overnight call per diem. She likes getting paid an hourly rate and being able to turn the pager off and leave without feeling obligated to stay and catch up on her charts, etc like the other "part time" salaried doctors are asked to do.

Unless you're extremely productive, I have often felt I would be more fairly compensated if I was paid by the hour than on a productivity model. I practice full-spectrum Family Medicine with a largely outpatient clinic focus. I have a large # of women and children as patients, thus lots of extended Well-Woman and Well-Child visits, which means I often spend twice the time for the same or less "productivity" as someone who sees 2 or 3 acute care patients in the same time slot with a lot less follow-up and comprehensive care. I am part time in theory, but as pulpo pointed out, that's not really ever true in this profession--it just means you need to accomplish the same amount of work in less time and/or are not compensated for the extra hours you inevitably end up working. In addition, in our current productivity compensation model, there is no pro-rating of productivity for part-timers and thus no chance of meeting the threshold needed to get a bonus (in our case, paid at a higher rate per RVU or Relative Value Unit earned based on services provided). So, if you are happy in your current setting, have average productivity compared to your peers and your hourly rate is reasonable, you probably are in a great position. Working part-time, even with the compensation frustrations, has been very rewarding for me personally and for our family--it can be done, and done well.

I am finishing up my fellowship in a surgical subspecialty and about to start negotiating a contract for a part-time job. Another female physician I trained with suggested having the contract list the agreed upon full-time salary, and then the percentage of that in days per week. For example, 3/5 of the salary is paid for working 3 days per week. The productivity is then based on 3/5 of the base salary, and is achievable. Does anyone else have experience with this? Or any suggestions?

I work in a large physician group that does exactly that. We are offered a salary and depedning on how many days you work, you get that fraction of the salary. My friend is in Peds and works 3 days per week, so gets 60% of her salary rate.

Thanks for the thoughts. When I was initially negotiating, my practice did not want to prorate the salary and productivity and only offered the hourly rate. One of the partner's wives works part time as a pediatrician, and that is how she is paid -- which is why I think they wanted to do it that way. I totally see your point, MomLAS, because I always work more than 50% of the hours, and at least I am paid for that time. On the other hand, I also have patients receiving infusions in our infusion center and don't see any compensation from that, and that revenue counts toward productivity for the "partner-track" physicians. Some days I'm frustrated, but other days I'm thankful that I have a job I like and a workable schedule. Compared to residency and fellowship, it's fabulous!