Your Productivity Bonus is Less Than Expected, What Now?

According to my employment agreement, the maximum productivity bonus I could reach in my first nurse practitioner job was somewhere around $25K. My base hourly rate plus the added bonus potential, which I obviously knew I would reach, added up to a pretty nice compensation package. A new NP grad, I had some serious plans for my $25K. Saving up for a down payment on a home and replacing my creaking, rattling, SUV were at the top of the list.

Unfortunately for myself and my neighbors forced to listen to my clanking car rattling into the parking lot, my first productivity bonus amounted to….drum roll….nothing! You can imagine my disappointment when I received that particular month’s paycheck. Frustrated, but assuming my newbie status was at play, I vowed to work even harder next quarter for the financial benefit.

It turned out that neither myself nor any of the more experienced NPs and PAs with whom I worked earned a bonus that year. A muddied explanation of the practice’s productivity structure was all that was offered.

While I don’t agree with and am still unclear about the way that particular practice outlined its bonus structure at the time, I neglected to handle the matter in an informed, assertive, and professional manner. If you encounter a situation where your nurse practitioner bonus is less than expected, take the following steps:

Step 1: Get Informed

Incentive bonuses for nurse practitioners typically come in one of two varieties. First, NPs may be paid a ‘discretionary’ bonus. Discretionary bonuses are subjective, based on opinion rather than numerical data. Second, nurse practitioners may receive a ‘productivity’  bonus. These types of bonuses are objective, based on metrics like RVUs billed or number of patient encounters. 

If you feel you’ve been slighted come bonus time, review your employment agreement. Is your bonus discretionary or based on productivity? If your compensation is productivity based, how is productivity calculated? Are the metrics required to reach a bonus clearly outlined in your contract or in other practice policy guidelines?

Step 2: Seek to Understand

Once you have a clear(er) understanding of your practice’s bonus structure, seek to understand where you fell short or reasons you may not have reached bonus status. Internal and external factors may be at play. Perhaps it is clear you did not reach your RVU goals, or neglected to complete documentation on time. Factors outside of your control such as decreasing patient volume may have also affected your bonus. Identify events, circumstances, and performance issues that contributed to your disappointing payout.

Step 3: Take It Up with Your Boss – Effectively

Once you understand your compensation structure and have evaluated factors that affected your paycheck, you may choose to take up the issue with your boss. To do so effectively, keep the following in mind:

• Avoid being defensive or confrontational. Rather, seek to understand your boss’ perspective. Asking open-ended questions like “Tell me about…” helps accomplish this in a non-confrontational manner. 
• Approach the interaction with the intention of understanding rather than an “I’m gonna get what’s mine” attitude. Ask for clarification about your compensation structure so you can adjust your expectations for the future.
• Taking the issue personally and/or bringing it up emotionally will hurt your efforts. 

Step 4: Decide What You Want Going Forward

Reassess where your expectations were off. Did the practice experience a challenge or unanticipated circumstances that lead to a decrease in patient volume? If so, is the situation expected to change for the upcoming bonus period? Unplanned circumstances may have derailed your bonus payout but could correct themselves.

If you feel your compensation isn’t being calculated fairly or metrics are unreasonable, think about how they might be adjusted in the future. If your employer is open to restructuring your bonus or discussing the matter further, present your ideas in a written, organized format. A letter may be your most effective approach. 

If your individual performance was to blame, identify a few practical ways you can improve for the upcoming bonus period. Ask your employer for you can take to meet expectations as well. 

Step 5: Maintain Workplace Relationships

Feeling slighted come bonus time can hurt. You may feel like your boss doesn’t like you or doesn’t appreciate the effort you put into your job. You may feel frustrated that your preferred methods of patient care don’t lend themselves to meeting bonus metrics commonly applied to nurse practitioners. Whatever the root cause of your lacking bonus, stress to your boss throughout your interactions that your disappointment lies with the issue at hand, not with your job overall. This helps communication flow in a way that neither party feels threatened and gives you the best chance of reaching understanding and a solution for the future.

Did your most recent bonus meet expectations?