When it comes to discussing your compensation requirements, make sure that you know what you’re entitled to and what you deserve. There are two myths clinicians need to be aware of.

Myth #1

“My employer says I can’t be put on an incentive or productivity bonus because it would be against the anti-kickback laws.”


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It is absolutely false for your employer to reference violation of the anti-kickback laws to justify not approving an incentive or productivity bonus. 

In 1972, Congress passed the anti-kickback law to protect patients and federal programs from fraud and abuse by curtailing the corrupting influence of money on health-care decisions. Straightforward but broad, the law states that anyone who knowingly and willfully receives or pays anything of value to influence the referral of federal health-care program business, including Medicare and Medicaid, can be held accountable for a felony. However, one of the 20 practices designated as a specific “safe harbor” or exception to the law, is employee compensation. It should go without saying that we have a responsibility to patients and the health-care system to make sure procedures and referrals are medically appropriate.

Myth #2

“A good negotiation strategy is to compare yourself to the average for other physician assistants and nurse practitioners in your area of medicine.”

This is completely false. Every practitioner should be compensated based on what he or she brings to the practice. This obviously includes monies collected for the services provided, but don’t forget all of the other income-generating duties you perform. Among other things, this includes hiring and training staff, taking calls, assisting the physician, facilitating the physician’s ability to see more patients or conduct more procedures, running a support group, and overseeing the office’s electronic health records.

The overall theme to your negotiations should be centered around what you, as an individual, are worth to the practice and how much the physician and practice benefit from your employment. Think back to when you applied to school.  Did you tell the admissions board, “I’m average. I just want an average education. I plan to provide average care to patients?” Of course not. Instead, you said, “I would make a great student and a fabulous health-care provider.” That that very same approach should be used when it comes to your compensation negotiations. It may be hard to toot your own horn, but in this situation, it is necessary.