Hospitals Tops in Physician Benefits

Physicians employed by hospitals enjoy richer benefits and potentially fewer administrative hassles, but physicians employed by private practice express higher satisfaction with their compensation packages, survey data shows.

Physicians working in physician-owned practices are most satisfied with their compensation packages when compared with colleagues working for universities or hospitals, a survey shows.

However, the 2014 Physician Compensation, Benefits and Recruitment Incentives Report from the St. Paul, MN-based Association of Staff Physician Recruiters also found that hospitals generally offer better benefits and recruiting incentives.

"A big trend we are seeing is that the hospital-employed physicians seem to be receiving better benefits and more recruitment incentives compared to those in the university setting and physician-owned practices," says ASPR Executive Director Jennifer Metivier.

"With the trends in more hospital employment, hospitals are doing all they can to entice physicians to become their employees. It is not surprising, honestly."

"Overall physicians are more interested in employment opportunities because they don't have to deal with the administrative and overhead issues. They come to work. They treat their patients. They do their paperwork and they go home. They don't have to worry about the business aspect."

Even though hospitals were able to offer richer benefits and recruiting packages and potentially fewer administrative hassles, Metivier says the survey shows that employed physicians working in private practice expressed the highest satisfaction with their compensation packages.

"That is because they are defining it and they are in charge of it themselves," she says. "They're happy with how they are getting paid because they're dictating. In a hospital or university setting, someone else is determining how they are going to get paid."

Of the 314 physicians in 26 specialties who responded, 44% employed by physician-owned practices said they received no funding for Continuing Medical Education compared to 17% of hospital-employed and 16% of university-employed physicians. They also were more likely to receive no time off for CME.

The same trends were seen with paid time off, sick time and recruiting incentives, ASPR reported.

Hospitals offered more signing bonuses, relocation assistance, student loan assistance, and malpractice insurance than other employers, with physician-owned practices offering the least.
"Hospitals and universities certainly have more capital and ability to offer some of those incentives," Metivier says. "You aren't going to find a lot of private practices finding money to pay for student loan assistance. That is something hospitals and universities are more likely to do just because of the financial situations that they are in. They have the capital available to offer some of these incentives and the additional time off, for example, for CME."

As a practical matter, Metivier says, physician-practices often don't have the staff to cover for absent colleagues.

"Whatever it is, they can't afford to have their physicians gone for long because there is nobody there to cover for them. Whereas hospitals have more physicians within the group or they have the ability to hire locum tenens to cover for them."

Physicians responding to the survey reported that they spend 11% of their time doing administrative work such as medical record documentation and chart reviews. However, 65% said they had no time built into their schedules for administrative duties. Physicians in university-owned practices were more likely to have designated hours for administrative work than those in hospital-employed or physician-owned practices.

"We were surprised to see how few hours were being provided for physicians to do that work," Metivier says. "They are spending 11% of their time doing it but a lot of them aren't getting a slot in their schedule to do it. They're having to do it at the end of the day after their clinical hours or squeeze it in where they can which diminishes their quality of life and takes away from their personal time."

It is ironic, Metivier says, that hospitals work so hard and pay so much to recruit physicians but risk losing them because they aren't given enough time for paperwork.

"That is an area that can be greatly improved upon if organizations want to keep their physicians happy. They need to identify more time for physicians to get their administrative work done within their set schedule," she says.

"If you can't keep your physicians happy they are going to go elsewhere and you are back to recruiting again, and that costs a lot of money to go through the process. You want low turnover and one of those key things for physician satisfaction is their schedule."