Q&A: Reducing pay for physicians who want to shed responsibilities

Q: We have a nine-physician pediatric practice with three offices that serve three hospitals. Two senior physicians would like to stop taking call, doing rounds, and working weekends, and they are willing to take a reduction in base pay. How would you suggest calculating that reduction? Is there a methodology that we could use?

A: Normally, physicians who attain a certain age and have been with the practice for a minimum of 10 years would not be required to take call. This load would be absorbed by the remaining doctors in the group, and there would be no reduction in the base pay because a majority of groups don't include this in the base pay. Rather, it's paid on a per-diem basis. Some groups pay their on-call physicians a per diem of $250 per day, for example. To determine what the per-diem rate should be, you would need to determine what that particular doctor's rate is and apply that to actual on-call hours. A new trend for smaller hospitals is to use hospitalists. These physicians basically work for the hospitals for all on-call work. They should be paid a per-diem rate too.