By all accounts, 2014 will be a watershed year for physicians and their practices. To name only two mandated initiatives: insurance plans purchased through the new healthcare exchanges became effective Jan. 1 and the beginning attestation for the Stage 2 rules of meaningful use rolls out. Practices have been assaulted on all sides by competing demands. Yet, after careful planning to survive bleak forecasts of reduced payer reimbursements and lower patient demand for care due to cost concerns, practices find themselves in a holding pattern when it comes to hiring and providing for their staff.
"I think [practices] are just trying to hold on, I think they are just trying to hang on," says Mary Pat Whaley, cofounder and president of Manage My Practice, a consulting firm based in Durham, N.C. Whaley feels that the pressure to freeze staff wages is easing slightly, but in general, she sees limited salary increases at practices. "At this point, I would say most practices are giving small increases to try to keep their employees solid with the fluctuations in the price of gas, the price of food … the money [for larger raises] is just not there," she notes.
According to the results of Physicians Practice's 2014 Staff Salary Survey, 42 percent of medical practices say they employ the same number of staff they did two years ago. Thirty-three percent of respondents have added staff over the same period. We surveyed close to 1,400 physicians and practice administrators across the country. The typical respondent was an independent practice with one to five physicians. Close to 50 percent said they employed between one and five nonphysician providers and administrative staff. The overwhelming majority, 83 percent, said they practiced in a traditional fee-for-service environment. And, fully three-quarters of all respondents expressed an inability to give significant raises to their staff, citing decreasing reimbursements (58 percent), practice expenses (16 percent), and the national economic climate (13 percent).
So, if there is limited money for giving raises, how will practices incent their staff to work harder and make a personal investment in their jobs? We asked our experts for tips and strategies that practices could use to maximize the staff they already have. Here's what they said.
*According to our 2014 Staff Salary Survey, most medical practices are holding firm on staff compensation. Here's what practices across the country are paying.
Full or part time?
Family physician Deborah Winiger practices at North Suburban Family Healthcare in Vernon Hills, Ill. She started out 17 years ago in a group practice, and has been in solo practice for the last 14 years. When she lost an associate three years ago, she brought on a nurse practitioner. Her staff is an amalgam of hours and positions, but it works for her and her employees. Together, two part-time nurses make up one full-time-equivalent position: a RN and a licensed practical nurse. The same applies to her front-desk position; two receptionists share one job. Even her mother helps out on a part-time basis.
Winiger says she didn't start out with the intent to hire only part-time employees. Rather, her staffing model grew up over time; from staff preferences and through necessity. "I mean it's just a cost benefit to me to not have full-time staff," says Winiger. "I have to say, I do offer some benefits to my people because they've been there [for a long time]." And, she has also given raises to her staff. "I'm probably the outlier in that my staff has gotten [salary increases] every year they've worked for me, except for one [year]." She says the raises are minimal, but she also provides bonuses at the end of the year. In this aspect, Winiger aligns with our Staff Salary Survey respondents, 71 percent of whom say they have no plans to give raises beyond cost of living increases.