The Good News about the Dreaded Phrase “Competitive Pay”

The third installment in our series Family Physician Competitive Pay

The phrase “competitive pay” is an invitation to negotiate.

You have seen the hollow phrases of “competitive pay” or “generous compensation” and the like when reading job descriptions for family medicine physicians. It often comes off as evasive or deceptive. Chances are you hate reading it.

What “competitive pay” usually means is the practice doesn’t know what they’re going to pay a physician. Small practices don’t know market rates because they don’t look often. These small practices want to answer the compensation question without losing applicants. Large, multi-state health systems make the compensation unclear in job postings because the person writing the job description doesn’t know the compensation.

These generic answers are not legally enforceable. That’s why they’re everywhere.*

When I talk to practice owners, what they are willing to offer depends on a wide variety of factors that they simply can’t guess about you as an applicant.

Here are some things that tip the scales:

  • Family ties to the area and likely to stay: greater pay
  • Great personality—even made them laugh during the interview: greater pay
  • A board action that wasn’t so bad you’re right out of consideration: lower pay
  • Board Certified through the American Board of Family Medicine: greater pay
  • Board Certified through the American Board of Physician Specialists: lower pay

“Competitive pay” is an invitation to negotiate.

That’s the good news. Hard and fast lines on compensation make the numbers easier to include in the job descriptions. They also make compensation inflexible.

No one got into family medicine because they love debating the ins and outs of someone’s compensation. Candidates usually want to make more money but don’t want to poison the well. Practices want great physicians but don’t want to be held accountable for paying top dollar for someone unexperienced. The solution is to have a facilitated conversation. Speak with a specialized, independent recruiter that works in family medicine every day.

Let’s say you’ve gone past the job posting and have actually gotten an offer. Oftentimes, physicians learn what competitive compensation is by seeing a few job offers. The average offer is higher than the average compensation. Here’s why.

For any given family physician opportunity, the location is fixed. They can’t do a thing about it. To attract more applicants to more rural places or smaller communities —they offer more money— and they offer it to more people.

Physicians get offered these positions then turn them down often, so these higher paying offers are a bigger part of the pie. Positions in highly sought-after cities like Charlotte, Atlanta, Nashville,  Austin, and Denver pay less and get offered to fewer people i.e., those offers are a smaller part of the pie.

If the doctors do end up accepting a high paying job in a rural community because of the compensation, they do what a lot of reasonable person would do. Work there for two years, absolutely rake it in, then ditch the smaller locations for places like Tampa, Florida; Dallas, Texas; and Los Angeles, California. The rural practice dusts off the “Doctor needed” sign. The Tampa family physician is still there.

A lot of job postings will claim to be competitive based on Medical Group Management Association (MGMA) guidelines. MGMA does have high quality information. There will always be doubts as to it’s validity. Be assured: their information is better than anyone else’s right now.**

If a practice tells you the percentile of MGMA they pay at, that has meaning. Being at or around the 50th percentile for MGMA means there are real numbers involved that they can actually be held accountable for.

Being “competitive based on MGMA guidelines” is meaningless. If they something along those lines, ask what percentile they pay at.

In speaking with the head of recruiting for large, rapidly expanding healthcare corporation, their lead internal recruiter told me their pay was competitive based on MGMA guidelines. Pressed for the percentile. they said they pay at the 25th percentile. That means three out of four family medicine physicians are getting paid more than their doctors. And that legally* qualifies as “competitive based on MGMA guidelines”.

All-in, job postings with terms like “competitive pay” or “generous compensation” are invitations to negotiate. Negotiating is uncomfortable and goes smoother when you and the hiring authority walk into the room thinking about similar numbers. If you’re looking for a new opportunity, talk with a specialized recruiter. You can email me, Ben Kennedy, at or call/text me at (540) 400-7641.

*This is not legal advice. I am not an attorney. Always consult an attorney regarding legal matters.

**MGMA’s information is better than anyone else’s and they charge accordingly. Their information is hard to get your hands on. MGMA monitors the internet and online forums. You either need to know someone with a copy or own a copy yourself. AAFP is trying to build their own dashboard which they’re aiming to have finished collected data the same day I’m writing this (11/14/23). They’re planning to have it go live on 12/15/23. As of now, I can’t say anything about its accuracy. We wait.



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