**Why Hospitals are Discreetly Limiting Top Doctors’ Earnings: Insights from Health Law Attorney Dennis Hursh**
In a recent conversation featured on KevinMD, Dennis Hursh, an experienced health law attorney with nearly 40 years of expertise in assessing physician employment contracts, examines a rising trend: hospitals are increasingly limiting physician salaries. These limitations often align with the 90th or 75th percentile of national standards.
**Reasons Behind Salary Limitations**
Hospitals defend this approach by expressing worries over curbing fraud and misconduct. The suggestion is that doctors earning at the higher percentiles may be perceived as partaking in illicit actions, such as receiving payments for referrals, a notion Hursh deems ridiculous. He contends that the idea that 10 to 25 percent of the highest-earning physicians are engaged in unlawful behavior is not only irrational but also harmful.
**Consequences for Physicians**
Elevated salaries are often linked to heightened productivity levels or working in less sought-after areas, yet the reliance on internal staff to determine “fair market value” introduces biases that favor hospitals. This tends to place the most productive doctors at a disadvantage. Hursh recommends that physicians obtain independent, third-party assessments of their compensation to protect against unjust caps.
**Broader Implications**
These salary limitations not only influence individual doctors but also have wider repercussions for the medical profession overall. Every year, entities like MGMA conduct surveys of employers, and the data gathered influences national salary standards. Consequently, if capped salaries for high-performing physicians are documented, it gradually diminishes the expected compensation thresholds throughout the sector.
**Guidance for Physicians**
For those physicians who encounter such stipulations in their agreements, Hursh recommends renegotiation, particularly if they rank among the top in productivity. It is essential to maintain transparency in productivity documentation.
In conclusion, this trend highlights a more significant issue concerning hospital practices that prioritize administrative financial stability over acknowledging physician productivity and commitment. Hospitals are encouraged to rethink these methods to prevent demotivating their most significant clinical resources.