Career and Life Planning Guidebook for Medical Residents

Recommended Tool Compensation Package Worksheet. You cannot make a good decision about which offer to accept without gathering all of the facts regarding compensation and comparing them to what you believe is acceptable. This exercise worksheet will help you make an objective evaluation of all the elements involved with the compensation offer. http://md.careers/E-23 R E A D : Post-Starting Salary Transition At some point, the “guarantee” in a guaranteed base salary might expire and you will find yourself being “at-risk” for a potentially large portion of your compensation. This might occur somewhere after the first contract year or not until your fourth contract year depending on your guaranteed salary provisions and practice ramp-up expectations. Going at-risk for production, typically measured in either wRVUs or net professional collections depending on the applicable compensation model, will require some basic understanding of productivity which we will cover in the next section. Going at-risk also requires some advanced planning and reporting to make sure you’re ready to have the safety net taken away. It is important to understand how compensation earned/paid is treated as taxable income on a W-2, 1099, or Schedule K-1. Make sure to ask the employer and consult your tax advisor for specific guidance. Fair Market Value and Commercial Reasonableness Standards Arrangements involving physicians are subject to a number of regulatory restrictions that require compensation for services to be at Fair Market Value (“FMV”). These include the Stark Law, the Anti-Kickback Statute, and tax-exempt organization regulations. The Stark Law limits the ability of physicians to have a financial relationship with entities that provide certain services to which the physicians are in a position to refer patients. The federal government has provided a list of Designated Health Services (“DHS”) subject to the Stark Law. The Stark Law prohibits a provider or his or her immediate family members from referring a government healthcare program patient for any DHS to an entity with which SECTION II: T MINUS TWO YEARS CAREER AND LIFE PLANNING GUIDEBOOK FOR MEDICAL RESIDENTS 230