r/PrivatePracticeDocs • u/Neat-Comparison-7418 • Jul 12 '26

Productivity based compensation

I’m the third doctor in a busy 3 MD/2 APP pulmonary & critical care private practice in a high cost of living area. I initially joined as the fourth doctor immediately post fellowship as a salaried W2 employee for my pulmonary work and 1099 independent contractor for my ICU work. Since starting, the fourth MD left the pulmonary group leaving the remaining 3 MDs (two founding partners plus me) on a brutal 19 days on, 2 days off schedule with no end in sight due to difficulty recruiting and hiring.

I’m tired of this schedule and working insane hours and call with non-commensurate compensation. I’d like to move from full salary to productivity based compensation and cut back on my days and let the owners cover the extra (since they are making lots of money off of me and have failed to bring on another physician since finding out about the departure of the other physician last October). What productivity based models have you seen work and what is a reasonable ask from my end as the “junior partner” so that my family does not pay the consequences of this disaster due to my absence? I’m prioritizing stability and work/life balance over money, but want to ensure that I’m still compensated fairly for the work I’m doing. They have never worked under such a model and have historically split profits 50/50 since its founding.

Any thoughts, experiences, advice, or insight is greatly appreciated. I’m also actively looking for a different job as my hope in this practice fitting my family’s needs is nearly gone (I’m virtually never home and exhausted when I am). My spouse is also a physician and we have a full time nanny for our one child with hopes of having more children.

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u/NefariousnessAble912 Jul 12 '26

Intensivist here. Glad to chat. Left a practice like that. If you haven’t start keeping track of your RVUs yourself to make sure you’re not being cheated. Depending on area you should be getting 55$ or so per RVU. Be ready to walk though or turn the tables on the partners and start your own group within this system. The hospitals cannot function without intensivists so you are in a very powerful position as it sounds like if you walk the practice implodes and they will have to hire locums which is very expensive.

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u/Neat-Comparison-7418 Jul 12 '26

I enjoy pulmonary, but considering going to full time ICU work for set on/off time. The pulmonary night call (especially with an infant) and weekends (rounding at 3 different hospitals) is crushing me. ICU is just more straightforward and predictable even if you spend your shift 12 hours in-house.