Associate raise demands

Q: My associate wants more compensation or she'll leave, but I can't afford it. How do I keep her?

A: You first need to find out why there is a demand for more money. It might be true financial need, but it also might be a way of expressing dissatisfaction with the work environment. In the event of the latter, most employees dissatisfied with the work environment leave anyway within 6 months or so, even if they get the raise. If the need is financial-and you can't afford it-perhaps the underlying productivity and profitability needs to be evaluated and corrected. "Unaffordability" tends to be a symptom of an underlying condition. Check your practice statistics against specialty benchmarks. The best overhead benchmarks are available from NSCHBC.org. The best productivity benchmarks are available from MGMA.com, especially if you can produce RVU statistics in addition to charges and collections. Often, lack of profitability is based on chronic undercoding, so you might have a coding evaluation performed. Offer her compensation with a reasonable base, plus a productivity incentive that is achievable once the practice is healthy statistically. Consider selling the associate part of the practice so that she develops an "owner's attitude" and helps you become more profitable.