Clinician pay do's and don'ts
A fair new pay plan can look like a pay cut if a clinician first sees it on a paycheck. Show each clinician last quarter's pay under the current and new plans.
Co-founder, JotPsych
Your new pay plan is ready for January, and your clinicians haven't seen it yet. How do you change their pay without losing anyone?
Show last quarter's pay under the current and new plans, face to face
Change pay once a year at most, with 30 days' notice
Show salaried new hires at month six what a share of collections would pay them
Making side deals on pay
Paying out every dollar the practice collects
Skipping the yearly pay plan review
Five of the six rules come from how Integrated Medical Services, a physician group in Arizona, changed pay. A clinician who sees last quarter's pay under the current and new plans hears about the pay change from you, not from a paycheck.
Three do's
Show last quarter's pay under the current and new plans, face to face.
Run last quarter's sessions under the current plan and the new plan, and show each clinician the total under each plan. Monique Delgado, former chief executive of Integrated Medical Services, a physician group in Arizona, met each specialty with her chief financial officer and a physician leader. "Here's your current compensation. Here's what it's gonna change to," she said.
Change pay once a year at most, with 30 days' notice.
Delgado's group wrote the once-a-year limit and the 30-day notice into its own rules, sent notice in December, and started the new plan in January. Starting your new plan on January 1? Send your notice by December 1.
Show salaried new hires at month six what a share of collections would pay them.
Delgado's group guaranteed new physicians a salary for their first year. At month six, the group worked out what a share of collections would pay each one, "so that they knew how they were trending." Let your most productive new hires move off salary early, as her group did.
Three don'ts
Don't make side deals on pay.
Give every clinician the same agreement. Put your pay plan in an addendum, so at your next pay change you edit one page, not every contract. Delgado's group replaced its many employment agreements with one. "I don't care if you're the president or the last guy that joined the company," she said.
Don't pay out every dollar the practice collects.
Keep money in your practice. Delgado's group once let its physicians take home "whatever was left," so nothing went back into the company. The group went to the bank for capital, and no one would lend it money. "We're on our own," she told her board.
Don't skip the yearly pay plan review.
Each fall, compare what your pay plan paid last year with your practice's collections and costs. In an April 2026 Medical Group Management Association poll, a quarter of medical groups hadn't updated how they pay physicians in three or more years.
In a Medical Group Management Association poll of April 21, 2026, 37 percent of medical groups said they review physician pay every year. If you haven't reviewed your clinician pay plan in three years, the plan still uses costs and collections from three years before.
For a plan that pays a percentage of collections, JotPsych's payroll report estimates take-home at the rate you set.
Book 15 minutes- Monique Delgado, former CEO of Integrated Medical Services, and Eric Passon, CEO of Ancore Health, “Revolutionizing Physician Compensation: Building Sustainable, Value-Driven Models,” session B2, Medical Group Management Association (MGMA) 2026 Annual Conference, San Antonio, September 28, 2026.
- David Raths, “Arizona Physician Group IMS Builds Foundation for Value-Based Care Success,” Healthcare Innovation, March 19, 2024.
- MGMA, “Falling behind on physician compensation plan review carries real risk,” MGMA Stat, April 22, 2026: poll of April 21, 2026, 258 applicable responses.