Compensation is much more than salary. If you find yourself focusing only on the initial salary offering, you may wonder why you added two more years of specialization when some internists are starting at the same level as nephrologists. As upsetting as that sounds, the good news is that starting salaries are short term and a career in private practice nephrology can be fulfilling; both, professionally and financially. As a partner you will have access to multiple revenue streams that include income from patient care and productivity bonuses or from ancillary income streams like medical directorships, joint ventures, clinical research, real estate holdings and more.
Most practices do offer a salary guarantee for the first few years of employment when a physician joins a practice. The expectation is that the physician will be self-supporting within a year or two and move to a productivity model of pay once partnership is achieved. Below are some common questions we are asked:
Q: Why is the starting salary for private practice lower than what hospitals offer?
A: Hospitals have greater financial resources to draw upon, allowing for a higher initial salary. Starting salaries in the private practice environment are portions taken from the existing partner’s own earnings.
Q: How can I make more money?
A: Investments, real estate, and medical directorship positions are all examples of ancillary income streams to a partnered nephrologist. Physicians whose salaries are in the 75th percentile are supplementing their income with arrangements like these. All of these options typically require some initial capital outlay and time commitments but the returns are most often favorable.
Q: How can I get more money prior to partnership?
A: Ask. You don’t have to accept the first offer you receive during contract negotiations. It is always within your right to ask for higher compensation as there are many paths to getting what you want. More vacation time, productivity incentives, incremental increases and loan repayment in exchange for a longer contract term are all ways to increase your bottom line. If asked in a respectful way, most practices will at least consider requests like these. Much of this will be dependent upon how well you present yourself during the interview and if your long term value is worth a higher initial investment. (see our blog about nailing your in-person interview).
As always, the DaVita SOURCE team is here to help you ask these potentially uncomfortable questions. Feel free to reach out to us at firstname.lastname@example.org. Our blog, the SOURCE, also offers many great snippets of advice to help you along your career search