Once you’ve found the physician you want to hire, the salary and incentive discussion usually invites similar questions from candidates about how they can expect to be compensated. However, as regulations and protocols have been modified in response to the pandemic, there are bound to be new questions to consider.
As you continue recruiting, get comfortable and familiar with these questions candidates may ask during your next compensation discussion:
Package Logistics
What type of compensation is it?
One of the first things a candidate will want to know about your offer is the type of compensation you’re offering. Whether it’s a guaranteed or a productivity-based salary, it makes an especially large difference based on your facility’s current climate and patient volume.
On one hand, a greater influx of patients could incentivize workers with a productivity-based salary to treat as many individuals as possible. On the other hand, an inconsistent and fluctuating demand for certain specialties could make a guaranteed salary more desirable to some candidates. Ultimately, this will differ from candidate to candidate based on their preferences, so be prepared that compensation type may be a factor of interest.
How are your compensation packages defined?
Whether or not the pandemic has required your health system to develop new benchmarks for determining appropriate compensation, candidates want to know what factors are impacting their salary and benefits.
You should expect questions about your organization’s business model, including how patient demographic, volume, payment-reimbursement and the facility’s location have impacted your compensation package’s structure in recent months. If salary is productivity-based, candidates will want to know if performance is measured using relative value units (RVUs) or a capitation method - and whether compensation caps will be in place.
Will I be eligible for at-risk incentives and bonuses?
For both new and experienced physicians, practicing at this time comes with increased risk. The question is, how proportionate is the reward? You may be asked if at-risk incentives - like hazard pay - are included in your package to counter more dangerous working conditions. Also be prepared to confront the topic of personal protective equipment, and keep in mind that your facility’s readiness to provide safety equipment is a standard that many physicians will want included in their agreement.
Depending on your financial standing as a health care organization, the initial surge of COVID-19 may have impacted the incentives your package can offer. While candidates likely won’t ask about your facility’s budgets and expenses directly, they will be wondering how things like sign-on bonuses and similar incentives have been affected. Be ready to confront any changes as to what your health system is able to offer at this time.
What are my repayment obligations?
Candidates know that contracts are binding, but they also realize that none of us can plan for the unexpected right now. Because of this, they will probably ask about repayment obligations in the case they can’t fulfil a requirement of their contract. For example, if your hire were to contract COVID-19 and become unable to work the amount of time contracted, will they have to pay off compensation or bonuses already received from your practice? Or have these obligations been made more adaptable to account for unforeseeable circumstances?
How will the implementation of blanket waivers impact compensation?
On March 30, 2020, the Center for Medicare and Medicaid Services (CMS) issued blanket waivers of sanctions under the physician self-referral law for COVID-19 purposes. These blanket waivers may be used without notifying the CMS, and relate to all federal health care programs as they impact the Anti-Kickback Statute. According to their explanatory guide, the waivers provide vital flexibility for physicians and providers in the fight against COVID-19.
Candidates may have questions about the functions of these waivers, where they can apply, what their restrictions are, how compensation might be amended and how loans or deferred/abated payments may be postponed until after any emergency orders have concluded. Refer to your organization’s legal team to find out how these applications will impact your package so you can talk through the finer details with your candidate.
Should I be prepared for the possibility of redeployment?
For multi-facility health systems, the need for physicians varies based on influxes of COVID-19 patients. However, it’s hard to predict exactly where you’ll see the greatest needs emerge. The possibility of redeployment may be on your candidate’s radar and come up during your discussion.
How great are their chances of being redeployed? If you do ask a new hire to relocate to a different facility than where they first agreed to practice, can they expect compensation for their adjustment?
What termination with cause and termination without cause provisions exist?
Right now, job security for newly hired advanced practice providers is difficult to ensure. As candidates consider your offer, they may ask about the likelihood of termination or being furloughed and what criteria are involved in making that decision. As you approach this, you may also want to acknowledge any provisions that exist for workers terminated with cause and without cause, and how those provisions have been outlined.
Benefits
What kind of insurance benefits does your package include?
It’s possible that liability, life and health insurance have never been more influential to a candidate’s consideration of your compensation package than they are now. Practicing during a public health emergency means candidates will be especially thoughtful about calculating their risk, and whether the health and disability insurance you can offer will be sufficient.
When it comes to treating patients, especially those diagnosed with coronavirus and other comorbidities, advanced practice providers may be particularly concerned about the inclusion of professional liability insurance in your package. Also be prepared to answer questions about tail-coverage, whether it functions through a claims-made or occurrence policy, and if your candidate will be responsible for the full or partial expense of acquiring it.
What kind of time-off privileges will I have?
As you discuss time off, and whether it’s paid or unpaid, candidates may ask if sick days and voluntary leave are pulled from the same bucket or if they’re applied differently.
Hypothetically, if a physician must quarantine due to exposure or contraction of COVID-19, have you factored that leave into their time off? Has your organization’s ability to offer maternal and paternal leave changed? Candidates will want to know if your health system’s fluctuating expenses and capacity could potentially limit their utilization of leave-related benefits.
How much flexibility do I have to adapt my own schedule?
As the virus applies pressure to health systems and their staff, a report by Advis Strategic Consultants shows that 53% of executives have identified staffing and burnout as a top concern.
Your candidates will want to know how flexible their schedules will be, and what kind of authority they’ll have to structure them around their individual and family’s needs. Will they need to compromise compensation for adaptability? Regardless, your prospect will want an explanation of how pursuing elasticity in their schedules could impact compensation, and how you prioritize work-life balance as an organization.
Compensation isn’t everything in an opportunity, but it certainly has an impact. Make sure you’re prepared when discussing it so you can give prospects the explanations and information they need to see the full value of your offer.
Alexandra Cappetta
