(Thank you to Ashley Blasi, O.D., for the guest post below)

My first associate position after graduating optometry school offered me a straight salary with benefits.  I was thrilled to be actually making a paycheck after eight years of going into debt and really did not think twice about any negotiation. A couple of years later an amazing opportunity was presented to me to join a different practice as an associate. I was excited to accept the position and eager to start but I first needed to make the decision on how I was going to be paid.

 

My advice: DO YOUR RESEARCH. I had the option of taking a straight salary or a percentage of my production. It is typical for a practice to pay 18-20% of gross collected and a healthy practice to pay upwards of 24-26% of gross collected. The contract was renewed yearly and I could change my mind after the first year. This was a very difficult and scary decision. That black cloud of school debt needed to go away ASAP. Obviously, you want to pick the option that rewards you the best. But how do you know?

Here are a couple of questions to ask before making your decision . . .

  1. Is the practice willing to schedule the majority of new patients with you? Yes favors PRODUCTION
  2. Ask the practice to see a copy of the schedule and pay special attention to how many new patients are scheduled. Also, look to see how far out the other doctors are booked.  Light Schedules (<1-2wks booked out) favors STRAIGHT SALARY
  3. Ask the receptionist how many new appointments they schedule on average per week? >10 favors PRODUCTION, 5-10 moderate risk for you, <5 go with STRAIGHT SALARY
  4. Where do most of the new patients come from? (online, word of mouth, friends or family of other patients) – The more removed the new patients are from the existing doctors the more likely they will accept the new doctor (i.e. – someone doing online search more likely to see the new doctor than a family member of an existing patient)  >50% of new patients removed from existing doctors favors PRODUCTION.
  5. How many charts (paper or electronic) have one or two visits >2 years ago and they haven’t been back since? <20% indicates that once patient visits the practice they tend to stay, this favors PRODUCTION

Also, the partners of the practice probably have an estimate of how much you should be expected to take in (gross collected) each month. Calculate your estimated take home required for you to pay your bills if you chose the option of production.

After crunching numbers and asking a list full of questions, my Type A planner personality picked a straight salary for the first year. Three months later I wished I had chosen production. It was a no brainer to go straight production when my contract was up for renewal the second year.

Lesson learned:  Production does offer more risk but it also can offer a fantastic return.

Ashley Blasi, OD is an associate at Drs. Fisher, Yarrow and Fleming, Optometrists, in Wichita, KS.  She has been with the practice for close to three years.  She is a success story of finding the perfect practice match and enjoying the fruits of a great contract.