By Francesca Mathewes

When Goldsboro, N.C.-based Southeastern Medical Oncology Center recruits a new physician, it no longer leads with a single number. That wasn’t always the case, said Nagesh Jayaram, MD, who has spent most of his 14-year career at the independent practice, which partnered with Nashville, Tenn.-based OneOncology about a year and a half ago while keeping its own business operations intact.

For years, Dr. Jayaram said, SMOC pitched physicians the way most hospital systems still do: with a base salary figure and little else.

“We used to just tell them what their base salary was, and that used to be what everybody went through,” Dr. Jayaram said.

That changed once the practice recognized how much value was getting lost in a single number. This is easy for a larger system to fold into a bigger figure without ever breaking it out for the physician looking at the offer.

“I think it’s really the kind of ancillary services that you do. How do you capture all those service lines? I think that’s one of the biggest things that gets lost with compensation,” Dr. Jayaram said.

Now, when SMOC presents an offer, it itemizes what used to stay invisible: the value of insurance coverage, the value of vacation time and the other benefits typically layered on top of base pay. Dr. Jayaram said that breakdown matters because hospital systems tend to present compensation differently than independent practices do, bundling those extras into the number they advertise rather than spelling out what each piece is worth.

“The true compensation that you get to your hand may be a lot lower than what the hospital system shows,” Dr. Jayaram said.

The dynamic he describes lines up with broader industry data. Physician productivity has climbed 7% since 2023, according to Kaufman Hall’s latest Physician Flash Report, while compensation has risen only 6% and reimbursement has actually declined — a gap that’s pushing hospitals and health systems to lean more heavily on subsidies to keep physician pay competitive, even as the base numbers physicians see can obscure how that pressure is being absorbed.

For a physician comparing job offers, that means two identical-looking base salary numbers can represent very different total packages, depending on what’s included and how clearly it’s broken out. Dr. Jayaram said SMOC’s goal in itemizing every component upfront is to give incoming physicians a clearer, apples-to-apples view of what they would actually take home. Many physicians don’t get this comparison until after they’ve already signed on with a larger system, he added.

As more independent oncology practices in small, physician-scarce markets are absorbed into larger systems, Dr. Jayaram said pay transparency has become one more way practices like his compete for talent.