The compensation structure at Mark Twain Medical Center rewards clinical productivity while providing the security of a strong base salary. Unlike pure productivity models that create constant financial anxiety, or flat salaries that fail to reward hard work, this hybrid approach offers guaranteed income with meaningful upside for surgeons who stay busy. First-year earnings potential reaches $585,389, with higher compensation available as you build your practice.
Hospital leadership has expressed flexibility on compensation structure, particularly for surgeons earlier in their careers. If you prefer more guaranteed income with adjusted productivity thresholds, that conversation is welcome. The goal is a compensation package that works for both parties over the long term.
Your financial foundation starts with a $400,000 base salary, positioning you competitively from day one. This base provides stability while you establish your practice and build patient relationships in the community.
Beyond base salary, the productivity component rewards surgical volume without penalizing you during slower periods. You earn $74 for each work RVU generated above 6,800 WRVUs annually. Dr. Gonzales currently produces approximately 8,500 WRVUs per year, generating meaningful productivity income above his base. As you build your practice, similar production levels become achievable.
Call coverage generates substantial additional income at Mark Twain. You will receive $1,500 for each 24-hour call day, including GI coverage. This rate reflects the hospital's recent increase to compensate surgeons for managing GI patients alongside traditional surgical emergencies.
The one-week-on, one-week-off schedule means you can anticipate covering approximately 180 call days annually, though the contract caps coverage at 200 days per year. At $1,500 per day, call compensation alone can exceed $270,000 annually. Combined with base salary, quality incentives, and productivity bonuses, total compensation for a busy surgeon can reach well into the $600,000 to $700,000 range.
The benefits package eliminates many expenses that erode take-home pay at other practices. Mark Twain covers malpractice insurance, practice expenses, state licensing, and DEA registration. These employer-paid costs can represent $50,000 or more annually at practices where surgeons bear these expenses themselves.
Health benefits extend to you and your family with medical, dental, and vision coverage. The retirement plan combines a 457 plan with a 403(b), both receiving a 6% employer match. This dual retirement structure allows significant tax-advantaged savings, particularly valuable for high-earning surgical specialists.
When evaluating this compensation package, consider the broader context. California's Gold Country offers significantly lower housing costs than the Bay Area, Sacramento, or Southern California metros. A surgeon earning $600,000 in San Andreas keeps far more purchasing power than one earning $700,000 in San Francisco, where housing alone consumes a vastly greater share of income.
The combination of strong compensation, comprehensive benefits, and reasonable cost of living creates genuine financial opportunity. You can build wealth, pay down educational debt, and establish long-term financial security while practicing the full scope of your specialty in a collegial environment.