The decision to seek employment or private practice is a vital one for a neurosurgeon's career. Both options have pros and cons with varying levels of financial, personal and professional outcomes, according to a Neurosurgery Market Watch report.
The 2018 Medscape Young Physician Compensation Report reported that 85 percent of physicians under 40 or younger are employed.
Here are five compensation models hospitals and health systems use when hiring newly trained neurosurgeons:
1. Base salary: Most employed physician compensation structures include a base salary, and usually exclude benefits, bonuses or other employer compensation. Typically, newly trained physicians are offered a guaranteed base salary for the first one to two years of employment.
2. Production and quality bonuses: Work relative value units are used to determine the time, effort and technical ability required to accomplish a procedure. wRVUs are used to calculate production bonuses, however bonuses based on achieving quality metrics are becoming more popular.
3. Call coverage compensation: The median call pay for neurosurgeons ranged from $62.50 per hour at non-trauma centers to $83.33 per hour at designated trauma centers, according to SullivanCotter's 2016 Physician On-Call Pay Survey Report. Call pay varies heavily depending on the facility and what is included in the service.
4. Initial-salary contracts: Newly-trained neurosurgeons joining private practices typically receive straight salary or a salary with the potential for bonus compensation, which allows them to steadily increase productivity while building up their patient list.
5. Sharing profit/loss: After the initial contract, partnership or ownership may be offered to neurosurgeons, which requires a buy-in. Profit/loss can be shared by: each partner equally, productivity bonus plus standard compensation, cost-center compensation or a combination of each method.