As cash-strapped practices across the country face declining reimbursements and increasing operating costs, something's got to give. Unfortunately for many medical practice staff, that something is their salaries.
"I think there's no question that declining reimbursement has a negative effect on our financial condition," says Delia Meek, a practice manager at a seven-physician hospital-owned clinic in Coshocton, Ohio, which has struggled to give its 23 staff members pay increases since 2008. "I try to think of ways to motivate my staff because I know that I can't give them a raise."
The results of Physicians Practice's 2013 Staff Salary Survey indicate that such challenges are becoming commonplace. A significant number of respondents say they have cut or frozen staff salaries and/or reduced benefits. Making matters worse, as practices struggle financially, many are asking staff members to shoulder more responsibilities. "With patient volumes constantly increasing, I think both the providers and the employees have stepped up to do more — to do whatever they have to do," says Meek.
While stagnant salaries and added responsibilities could be a recipe for high employee turnover and poor job satisfaction, that's not the case at Meek's practice. She has not lost any employees due to salary-related issues. In fact, she says, her staff is working harder than ever. "They strive every day to efficiently utilize our organization's resources in order to keep going."
To help your practice foster such a productive and positive staff despite the financial pressures you face, we asked Meek, other medical practice leaders, and consultants to weigh in. Here are some surefire ways they said practices can keep morale and productivity high during tough times.
* Are your staff salaries in line with your peers? Find out with our 2013 Staff Salary Survey data.
Troubling trends
The results of our 2013 Staff Salary Survey indicate just how many practices are struggling to fairly compensate staff members. A third of the nearly 1,000 respondents said they have cut or frozen salaries at their practices in the past five years. In addition, a majority said they have no plans to give raises in 2013. Of that group, two-thirds cited declining reimbursements as the reason.
"Pretty much everybody in healthcare is fighting the continuing battles of expenses rising and reimbursements getting lower," says Mary Pat Whaley, a practice administrator for more than 25 years and founder of Manage My Practice, a consulting firm in Durham, N.C. "One of the biggest expenses that a medical practice has is their staff, and for most practices, they're just really not able to offer any increases to their staff." Worse, Whaley says this is not a new trend. Staff salaries have remained relatively "stagnant" the past two to three years at most practices.
And it's more than just thin paychecks that are hurting employees. Benefits have followed the same trajectory. In each of the last three years, about a fifth of practices said they had reduced benefits in the previous five years.
When specific benefits are considered, the trends are even more troubling. In 2010, 97 percent of respondents said they offered staff members paid vacation or paid sick time. This year that dropped to 86 percent of respondents. Also in 2010, 70 percent of respondents said they offered retirement plan matching; this year only 51 percent said they do.
In addition, more practices are asking employees to pay a portion of their health insurance, says Judy Bee, a principal at Practice Performance Group, a management consulting firm in La Jolla, Calif. "That used to be a very rare thing, but boy it's getting far more common because of what's happening with the rates."
