Being paid outside the collective bargaining agreement can have many advantages for senior physicians. In addition to a higher salary, more vacation days or a higher training budget can also be agreed in a non-tariff contract (AT contract). AT contracts also offer advantages for the clinics: they can demand more performance for higher pay and making the remuneration more variable opens up opportunities for refinancing.
The following article explains what needs to be taken into account with non-tariff contracts and what salary senior physicians can expect.
Non-tariff or according to tariff? This is how the earning potential is structured
As you advance to senior physician, you take on more responsibility and more management tasks. This also comes with higher pay . At a university hospital, senior doctors are paid according to the collective agreement for doctors from the collective agreement of the states ( TV-Ärzt TdL ). The salary is between 8,164 and 9,331 euros gross per month. This corresponds to an annual salary of up to 111,972 euros, excluding Christmas and vacation pay. At municipal hospitals, the collective agreement for doctors from the Association of Municipal Employers’ Associations ( TV-Ärzte VKA ) applies, which provides for a gross salary of between 8,021 and 9,167 euros per month, i.e. up to around 110,000 euros per year. The exact salary depends on the professional experience. We have summarized all collective agreements in this overview.
However, the average annual income of senior physicians in Germany is significantly higher. According to the Kienbaum remuneration report 2019, it is 136,000 euros, 30,000 euros more than in the previous year. The earning potential for senior physicians is improving somewhat more slowly than for the entire medical profession, but is steadily increasing. One reason for this is that numerous clinics now offer their senior doctors the opportunity to be paid outside the collective agreement.
The non-tariff employment contract is no longer a rarity today. Many hospitals, across all providers, provide their senior physicians with an AT contract from day one. This is the conclusion reached by the consulting agency Rochus Mummert Healthcare Consulting. The remuneration is between 130,000 and 150,000 euros per year, and senior doctors can even earn around 170,000 euros.
AT contracts: Higher wages for more performance
Salaries not only differ based on professional experience, there is also a wide range between individual disciplines. The Kienbaum report quantifies the average salaries for selected specialist areas as follows:
- Surgery : 148,000 euros
- Internal medicine : 142,000 euros
- Gynecology : 135,000 euros
- Orthopedics : 135,000 euros
- Radiology : 134,000 euros
- Anesthesia / intensive care medicine : 133,000 euros
- Urology : 132,000 euros
- Pediatrics : 131,000 euros
- Neurology / Psychiatry : 127,000 euros
- Geriatrics : 111,000 euros
According to Rochus Mummert Healthcare Consulting, an AT contract can even result in salary outliers of up to 200,000 euros in certain specialist areas. At the top are specializations such as interventional cardiology, neuroradiology and spine surgery. If you add up bonuses, income from target agreements, pool activities and additional income, you can earn up to 230,000 euros per year.
In return for the higher wages, the clinics also demand more performance. Sometimes they require specialist knowledge and special medical skills, sometimes they require leadership qualities and the willingness to take on tasks such as project or department management. Anyone who meets the requirements and is willing to do more can secure additional benefits in addition to higher remuneration with an AT contract. These include, for example, more vacation days, a higher training budget or the option to complete training sessions at other locations on a set number of days.
AT contracts: negotiation skills are required
If you want to get as many advantages as possible from a non-tariff contract, negotiation skills are required. While salary and benefits are clearly defined in the collective agreement, there is much more freedom when it comes to structuring non-collective agreements. Before you decide on an AT contract, you should also consider the consequences. A collective agreement also brings with it advantages, for example the automatic salary increase based on professional experience and the maintenance of a classification once achieved. If you sign an AT contract, you usually have to negotiate each salary increase separately. In addition, the classification into a salary level can be limited. For example, your salary can decrease if you have to give up certain areas of responsibility after a set period of time.
However, senior physicians no longer have to fear legal pitfalls. If flat rates are specified in the AT contract, it must be specified exactly what they apply to. For example, if the contract stipulates a flat rate of 20,000 euros per year for overtime, the contractual partners must define exactly what number of overtime hours will be offset against this. The senior physicians are entitled to separate remuneration for each additional hour of overtime. If you still fear that you will be taken advantage of, you can have the AT contract checked under labor law. In addition to the Marburger Bund, the legal departments of professional societies also offer this opportunity. However, the institutions are keen to make their target agreements fair in order to avoid dissatisfaction.
AT contracts: Advantages also for clinics
Senior physicians can secure a higher salary and more benefits through an AT contract. However, remunerating them outside of the collective agreement also has advantages for the clinics. You also gain more flexibility when it comes to remuneration and can therefore retain talented specialists.
AT contracts also offer clinics the opportunity to refinance the increasing salaries for senior physicians and other medical specialists. By making the compensation components more flexible, they can ensure that they have more money available to compensate for the higher compensation.
Switch from the collective agreement to the AT agreement
What chance of non-tariff pay now exists for senior physicians who have already been working under the collective bargaining model for a long time? That depends on the respective employer. Some houses provide for a collective agreement with several levels. From a certain level you automatically receive a non-tariff regulation. Others do not allow switching between models or only in exceptional cases. Those who stay with the same provider for a long time and pursue a career in the same company often find it more difficult to agree on compensation above the market salary. It may therefore be worthwhile for senior physicians to consider changing employers.
- : public
