Most new physicians receive compensation not from salary alone, but from a combination of salary and clinical productivity.

In general, contracts that are more heavily weighted toward the salary component provide a more dependable income, but there is no incentive to see extra patients or work harder. On the other hand, a contract that is heavily weighted toward a productivity arrangement has the potential for greater earnings. However, contracts with a large productivity component may have important shortcomings that deserve careful attention. For example, how is productivity defined? Is it related to patients seen, billings, or collections? If related to collections, how efficient is the institution’s collection system? What percent of the gross billings are they able to collect? Are the collections “taxed” in any way? At some institutions, fees are deducted from your collections to defray the cost of the clinical operation. You may be required to pay a share of the clinic the overhead, your malpractice insurance, and equipment needs such as beepers, cell phones, white coats, etc.