A few years ago, something started bothering me.
I kept getting called in to “fix” physician compensation plans. But even when the math was solid and the incentives made sense, the same problems kept showing up: physicians were disengaged, leaders were frustrated, access was still tight, and turnover still loomed.
I started thinking that maybe compensation wasn’t “broken” after all. Maybe were asking it to do something it just can’t do.
Compensation can reward behavior. It can reinforce priorities. But it can’t manage our practices.
The more practices I worked with, the clearer it became: before we tweak formulas or adjust incentives, we need to pay closer attention to the person wearing the white coat.
What actually drives our physicians? What do they want from their work? What do they need in order to do it well?
When those questions go unanswered, we see:
- Great candidates turning down good employment offers
- Physicians complaining
- Productivity plateauing
- Burnout rising
- Incentives just not working
I think the path forward is actually pretty simple:
We need to lead physicians the way we lead the rest of our teams.
If you just rolled your eyes or thought something like, “He doesn’t get it”, I understand why. We’re taught early on to put physicians on a pedestal. And in physician-owned practices, they’re also your bosses, which adds a tricky power dynamic. So instead of setting clear expectations, we hesitate. We think:
Who am I to tell my physicians what to do? They’re physicians.
But when productivity slips… when charts stay open… when coding errors show up… boss or not, we still find ourselves stepping in. Nudging. Pushing. Hoping the physicians change.
It’s no wonder why so many practice leaders like you tell me that managing physicians is the hardest and most draining part of their job.
So, ask yourself: How can you address productivity issues, burnout, frustration, and turnover, besides relying on physician compensation to do all the heavy lifting?
Because at the end of the day, physicians doing what they’re supposed to be doing is the single biggest driver of a practice’s success.
If you’re wrestling with these issues in your own practice and want to talk through a more practical, human-centered approach, I’m always happy to compare notes. You can schedule a Practice Strategy Session if it’d be helpful to think it through together.
