Monday, March 27, 2023

Responses to Date: Effective Compensation

Michael Johnson

I wanted to post the preliminary replies to my question regarding effective
ways to profit share in the office. Benefits are coming more into play,
especially when you consider health care premiums increasing by 40% or more
this year alone. I had some additional food for thought:

If compensation is based on performance, how does that affect those
patients that are considered “low dollar” or “low return on investment”?
Is the responsibility “shared” for the care of these types of patients? Is
there a different type of model that works to take care of this situation;
ie. The Assistant Model, etc.?

What about a shared pool of compensation, besides individual percentages
that encourages the practitioners to “play nice” with each other?

Responses to date:

+ I make an industry standard salary and get quarterly additions based on
the amount of work I’ve done. I have really enjoyed this model. I have a
set monthly target for revenue to hit (depends on CO.CPO,CP,fitter, etc)
and will make a certain percentage back above that set amount. In my
opinion, our team is much more competitive which spurs on the ‘want’ to do
better than the next guy in line. We’re much more likely to set up an in
service, stay after hours to ‘make budget’, and work towards a common
goal. I’ll be curious to see what your responses are. Thanks for asking!

+ We are a large company with operations in 5 states and 24 offices. At our
organization we pay a competitive salary and offer a bonus/incentive if the
practitioner meets or exceeds budget goals. This is graduated based on the
amount over budget. The budget of the practitioner does increase every year
a slight percentage and is based on actual sales of the previous year and
not necessarily the budget goal for that year. We have looked at making any
bonus reflective of actual profit per practitioner, but are still trying to
figure out the best way to do this. I hope this helps, I would like to
know what others are doing and maybe at what frequency.

+ I am a staff practitioner at a small/moderate sized company. I receive a
salary only with no commissions. The way I see it, I am a healthcare
provider, not a medical device sales rep. Therefore, I find the idea of
commissions based off of my ‘sales’ to be completely inappropriate for the
job. I don’t think anyone is opposed to an end of year bonus, however, I
think a substantial commission structure can easily compromise quality
patient care.

+Great topic and one we would like to improve on for our team. I have
found that once people have a salary, they are hesitant to go with lower
salary with higher incentive pay. So, you can incorporate at time of raises

+ Thank you for posting this as I see the relevance across the country.
I receive a base salary only, $200/mo for individual Med insurance (not
family), and no 401K benefits. My experience is this industry is
unrealistic about what practitioners are paid and will therefore see a drop
off of tenured practitioners in the next 5-10years that find other options
outside of seeing patients. Unrealistic non-competes combined with
minimized pay, blamed on decreased ins reimbursements rather than lean
business practices will ultimately be the demise of many current O&P
students taking out $150K in loans between undergrad and grad school. The
profit margins of this industry far supersede most other industries yet the
business practices aren’t optimized to reciprocate what practitioners bring
to the table. I hope this industry opens its eyes and either provides
better compensation, or at least provides adequate benefits to similar
health care colleagues.

+ Salary plus 2-4% annual salary increase based on merit, then annual
review of national averages for market adjustments when needed.

+ Would be interested in your responses. I part own a medium sized P&O
clinic in Australia (6 clinicians) and this is something we have wrestled
with in terms of the equitable way to do this, especially between P&O
staff, whilst maintaining our important focus on clinical excellence (not
just financial output). Currently we just pay above wages with occasional
bonuses for productive staff (once/twice a year often coinciding with
leave) Looking forward to your replies & discussion.

+ I’m not an owner….I’m a full time working practitioner. I’m a #2
employee; I have a competitive salary with a percentage bonus of the
collections that exceed a pre-set volume. I’m curious as well to see if
there is a trend in this business. I hope you get a lot of responses to
create a decent sample size for your results!

+ Excellent question….. This was the core of one of the conversations
that we started in small groups at least January’s Leadership event. It
didn’t get as far as I was hoping for, but the idea was there! I am at the
point of considering restructuring my salary schema– I like the idea of
some sort of hybrid model of salary- mix of base and then individual and
team based incentives … just not sure of the model yet. It all needs
great data to work though, and a very high level of transparency.

Please feel free to reciprocate and I’ll share the additional comments – I
do have a few more thoughts on the matter as well.

Best Regards,


Michael S. Johnson, CPO
OrthoPro of Twin Falls, Inc.
1437 Parkview Drive
Suite 200
Twin Falls, ID 83301
734-0766 fax


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