Fam Pract Manag. 2005 Mar;12(3):74.
Semi-retirement within a productivity-based group
I am trying to establish a “semi-retirement” plan with my current group. Our current financial package involves fixed expenses that are shared equally by all members and a productivity expense tied to the amount of business each physician generates relative to the rest of the group. This formula does not lend itself to any work reduction, as I would be using a greater share of income to meet expenses, both fixed and generated. Do you have any suggestions?
The fixed/equal aspect of your formula is obviously not conducive to semi-retirement, but the productivity-based share of overhead is favorable to members of the group who are “less productive” because of part-time status. You may want to negotiate a package for yourself based on the productivity piece alone, or ask to be taken out of the formula entirely and compensated according to a straight percentage of your collections. To negotiate this you will have to demonstrate benefits from your association with the group, such as your past contributions to group growth and development and your ability to transition long-time patients to others in the group. Make a case that you should be treated differently from the current model because of your long service.
Salary comparison resources
What resources can I use to compare my salary to other physicians’?
The AAFP conducts an annual survey of physician earnings that is broken down by census division, type of practice, location, gender and age. The results of this survey are posted on the AAFP Web site at https://www.aafp.org/careers/hunting/salaries.html.
If you are interested in more detailed information, the American Medical Association has a publication titled Practice Patterns of General/Family Practice, which covers net income, total revenue, total expenses, employment status, weeks worked, hospital utilization and managed care involvement. This item is available for purchase at http://www.ama-assn.org. Once the page loads, click the “Bookstore” link and search for the title.
A third resource is the Medical Group Management Association’s Physician Compensation and Production Survey, which provides detailed information to help practices assess the essential links between pay and performance. This item is available for purchase at http://www.mgma.com. Click on the “Store” link and search for the title.
Appointment of counsel
Can I hire my own attorney to represent me in a malpractice case, or do I have to use the attorney my malpractice insurer provides?
You should be able to hire your own private counsel in place of the defense attorney selected by the insurance company without jeopardizing the indemnity coverage. However, you will have to pay for the services of private counsel without the help of the insurance company. The legal fees and costs to defend medical malpractice cases are quite significant, even at the reduced rates that insurance companies are able to negotiate with firms that specialize in malpractice defense. If you replace defense counsel with private counsel, you could be giving up a significant benefit of the insurance policy.
In certain circumstances, it is wise to hire private counsel to help analyze the litigation themes, expert witnesses and the settlement strategy. Private counsel can provide valuable assistance in pressuring a reluctant insurance company to pay a settlement demand. In certain cases, such as when punitive damages are alleged, the insurance company may even recommend that the physician retain private counsel. This is especially likely if part of the award might not be covered by the insurance policy. However, in this role the private attorney is more of an adviser and will not be able to actively question witnesses or address the court except in limited matters.
A physician can always ask the insurance company to assign a new lawyer if there is a good reason to do so. For example, the physician may want to work with a particular lawyer who has represented him or her in a prior case and is especially familiar with the medical issues involved in the case. Also, the physician should be able to insist that the insurer appoint a new lawyer to avoid any potential for a conflict of interest to develop during the case or in settlement negotiations.
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