Contract & Benefits

Physician Recruitment Process and Compensation Overview

This is a flat-compensation 1099 independent contractor position with a base range of $270,000 to $285,000 annually based on experience. San Antonio Regional Hospital guarantees the first-year base salary, providing income stability while the clinic builds toward full capacity. A group productivity bonus has been paid every year for the past 10 years, ranging from $10,000 to $25,000 annually. At the high end of the base and full bonus, total cash compensation reaches approximately $310,000, which approaches but does not reach the 25th percentile for Internal Medicine: General in the Western region per 2025 MGMA benchmarks. The physician's direct patient volume is minimal by design, reflecting a supervisory and teaching role rather than a traditional production-based practice, which limits upside under a standard production model but significantly reduces clinical burden relative to peers.


*This model includes assumed and/or estimated inputs where data was not provided. Assumptions are clearly marked. Final compensation details are to be confirmed by the employer.

Variable Value
Clinical Days per Week 4.5 (Mon–Thu full day; Fri half day)
Clinical Hours per Week 36 hours
Admin Time Friday afternoon
Direct Patients per Day Up to 5 (worst case; typically fewer)
Weeks Worked 48*
Base Compensation Range $270,000–$285,000
Year 1 Salary Guarantee Guaranteed by SARH in Year 1
Incentive Threshold N/A — flat compensation structure
Bonus Structure $10,000–$25,000 (group productivity; 10-year history)
Annual Merit Increase 2–4%
Sign-On Bonus $5,000–$10,000


Production Calculations

Metric Formula Value
Annual Direct Patient Visits 4.5 days × 5 patients × 48* weeks 1,080*
Supervisory Encounters Overseen 4 residents × 8 pts/day × 48* weeks 1,536*
NP Encounters (Reference Only) 1 NP × 15 pts/day × 4 days × 48* weeks 2,880*
Total Clinic Volume (Est.) Residents + NP + Attending ~5,496*
Production Model Type Flat compensation; no wRVU or collections inputs N/A


Compensation Model

Component Low Scenario High Scenario
Base Compensation $270,000 $285,000
Group Productivity Bonus $10,000 $25,000
Total Cash Compensation $280,000 $310,000

Total Compensation = Base Salary + Bonus


Market Benchmark Comparison

MGMA Source: Internal Medicine: General, Western Region, 2025

Metric Calculated Value MGMA Percentile Interpretation
Total Compensation — Base Low $270,000 Below 10th ($274,106*) Below market floor for Western IM
Total Compensation — Base High $285,000 10th–25th percentile* Entering lower market range
Total Compensation — High Base + Max Bonus $310,000 Approaching 25th ($316,157*) Near 25th percentile with full bonus
Direct Patient Visits 1,080* Below 10th percentile* Supervisory role; not a standard production model

Market Alignment Rating: Potentially Unbalanced Compensation Structure

Compensation falls at or below the Western 10th percentile at the base level. With the maximum historical bonus applied to the high-end base, total compensation approaches but does not reach the 25th percentile. The supervisory and academic nature of the role means productivity is not comparable to a traditional IM panel practice. This analysis supports a negotiation for a higher base given the clinical oversight, academic responsibilities, and ground-floor investment the physician is being asked to make.


Three Year Projection

Year Base Bonus Merit (3%*) Total
Year 1 $277,500* $10,000 $287,500*
Year 2 $285,825* $17,500* +$8,325* $303,325*
Year 3 $294,400* $17,500* +$8,575* $311,900*

Year 1 = Base midpoint applied ($277,500*); bonus shown conservatively at low end during ramp period.

Year 2 = Full production.

Year 3 = Year 2 × 1.03.


Malpractice Coverage

Detail Value
Policy Type Physician obtains own policy (1099 structure)
Premium Facilitation Premier Medical Group provides malpractice insurance contacts
Premium Reimbursement Covered by Premier Medical Group as a bonus payment
Tail Coverage Physician's responsibility; not provided by employer
Typical CA Coverage Limits $1M per occurrence / $3M aggregate*

Part 2: Benefits and Additional Compensation

This is a 1099 independent contractor position. No employer-sponsored benefits are included. The items below fall outside the financial model above.

Additional Compensation

  • Sign-on bonus: $5,000–$10,000, negotiable based on candidate fit
  • Annual merit increase: 2–4% per year
  • Year 1 salary guarantee: Base compensation is guaranteed by San Antonio Regional Hospital
  • Moonlighting: Optional weekend hospitalist shifts available at approximately $1,500 per 12-hour shift; flexible timing

Benefits

No employer-provided benefits are included with this position. Premier Medical Group offers contractors access to the following resources:

  • Malpractice insurance facilitation through Premier Medical Group (premium reimbursed; see Part 1)
  • Private CPA and accounting support available upon request
  • Private banking relationships available upon request

Physicians structured through an S-corp or LLC may be able to deduct health insurance, CME, retirement contributions, vehicle expenses, and other business costs. Independent financial and tax advice is recommended.

W2 Option

A W2 employment arrangement is available for candidates who prefer it, though the employer's preference is 1099. Candidates considering W2 should be aware that California state income taxes will significantly reduce net compensation relative to the 1099 structure.

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