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    Tips for setting salaries and dealing with raise requests at your practice


    Keith Borglum medical practice physician salaryKeith Borglum, CHBCIt is often difficult to determine how much to pay a particular staff person, and how much to pay them in relation to other staff in the office. This difficulty can be compounded by many factors.

    Both employers and employees sometimes confuse salary and wages. Salaries are fixed amounts of pay per month. A wage is an hourly dollar amount. Most full-time staff work 2,000-2,200 hours per year. When paying a salary, you would think that you have a dependable, fixed amount for your budget, but that’s often not the case depending on the job description and the laws of your state. And job descriptions and laws are commonly in flux.

    Many states have laws about which staff can be on a fixed salary. Often, salaried staff have to be either licensed personnel using their licensed skills more than 50% of the time on their job, or managers supervising at least five persons whose jobs the manager does not perform.

    It can be tricky. Is your RN actually doing tasks requiring an RN license, or is s/he acting primarily in the role of a unlicensed medical assistant more than half time? Or do they spend time as a manager? If your office manager is managing five other staff, and you do a “reduction in force” by one person, what do you do? In both of these cases, you might need to be paying overtime wages, whether or not these persons are salaried.

    Salaried-staff are often due overtime wages by law if overtime is worked. Just putting them on a fixed salary does not circumvent the labor laws of your state. These are questions best answered by a labor attorney in your state, or more cost-effectively by just reading the employer guides provided free by your state Labor Board, Chamber of Commerce, or private vendors.

    Factors affecting pay

    Practices in high cost of living and urban locations often need to pay more to attract good staff than do practices in suburban locations.

    Keith Borglum, CHBC
    The author is a practice management consultant, appraiser, and broker in Santa Rosa, CA.


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