SAN DIEGO – Cash is king, but it’s probably not the best way to make physicians feel appreciated. A flat-screen TV, a vacation, or a chance to take a professional development course, on the other hand, are all good ways for practices to recognize high-quality work and motivate physicians, according to Dr. John Nelson.
Dr. Nelson, a principal at Nelson Flores Hospital Medicine Consultants and a past president of the Society of Hospital Medicine, said it’s important to compensate hospitalists well. But just adding on cash bonuses doesn’t do much to energize employees and convince them to stay with a group," he said at the annual meeting of the Society of Hospital Medicine.
"Cash compensation is generally seen as an entitlement, so in most cases it doesn’t wind up being much of a motivator," he said in an interview. "It might help encourage someone to take a position in your practice, but it probably won’t do a lot to change their performance."
Base salary, health benefits, vacation time, seniority-based pay, and cost of living adjustments are all standard compensation that physicians expect to receive.
Practice leaders should instead consider offering nonmonetary incentives to their physicians, Dr. Nelson said. While cash bonuses can be viewed as cold or unemotional, nonmonetary awards have the potential to be memorable and special for employees. And while $100 is always just $100, a nonmonetary award can often have a higher perceived value.
Here are some nonmonetary incentive options:
• Write a note of thanks for doing a good job.
• Award a trophy for work in improving quality of care.
• Offer a promotion or a new title.
• Pay for attendance at a professional-development course.
• Provide a chance to contribute ideas to the group or hospital through one-on-one meeting with leadership or by leading special projects.
• Offer gifts such as vacations, televisions, or gift cards.
There are a number of different ways that these types of awards can be structured, said Dr. Nelson, who is also director of the hospitalist practice at Overlake Hospital Medical Center in Bellevue, Wash. They can be offered as recognition to teams or individuals. They can also be set up to celebrate milestones or to honor important achievements.
When designing a plan, Dr. Nelson said it’s important not to set up a reward system that creates a feeling of unfairness and produces strife within the group. Group leaders also need to keep in mind that nonmonetary awards, such as trips or gift cards, still count as compensation under the Stark Law and anti-kickback regulations. This is especially important for physicians who contract with, but are not directly employed by a hospital.
These types of awards do carry some cost for employers, but not nearly as much as a cost of living raise, for example. Exactly how much to spend will vary, Dr. Nelson said, but it should be a small percentage of the physicians’ overall salary, as low as 1%.
"If structured in the form of a nonmonetary reward, such as recognition, promotion, [or] professional development, that might be enough to inspire and encourage good performance on the part of the hospitalist," Dr. Nelson said.