Splitting fees between practitioners: the method that prevents disputes

There is one subject nobody raises the day a colleague joins the practice, and that everybody ends up raising six months later: money. At the start, all is well. Activity is modest, the days look alike, and you tell yourself it can wait. Then one practitioner sees three times as many patients as the other, a third one arrives, a receptionist is hired, overheads rise — and the question becomes unavoidable: who produced what, and who gets what?

In most Algerian practices this conversation happens too late and in the worst conditions: at the end of a busy month, over an incomplete cash book, with two memories that do not remember the same thing. It is almost never the percentage that causes the conflict. It is the impossibility of checking the figure.

Why the split becomes an issue as soon as there is a second practitioner

As long as a doctor practises alone the question does not arise: he collects, he pays the overheads, he keeps the rest. The moment there are two, three things appear at once. First, individual production: each practitioner generates his own volume of consultations and procedures. Then shared overheads: rent, electricity, the receptionist, consumables, the software — none of which can be attributed to a single doctor. Finally, shared procedures: a patient seen by one and operated on by another, an X-ray taken by the practice and read by a practitioner.

The split is nothing more than the contract binding those three realities together. And a contract, to hold, has to rest on figures everyone can look at. That is exactly where most practices fail: the rule exists, sometimes it is even written down, but the data needed to apply it is nowhere to be found.

The three models you meet most often

There is no good model in the abstract — there are models suited to a given activity, a given level of overheads and a given level of trust. In practice, three broad families cover almost every case.

• Percentage of production: each practitioner keeps a share of what he billed, the practice keeps the rest to cover overheads. Easy to understand and highly motivating, but hard on a practitioner who is starting out or whose specialty generates fewer procedures.
• Fixed levy: the practitioner pays the practice a monthly amount and keeps all his fees. Readable and predictable for everyone, but harsh in quiet months and very favourable to high producers.
• The mixed model: a moderate base levy topped up by a percentage above a production threshold. Fairer over time, but it demands rigorous tracking — without reliable figures it becomes unmanageable.
• On top of that there are almost always special rules: technical procedures shared on different terms, on-call duty paid separately, discounts and free visits charged to whoever granted them.

Whichever model is chosen, it will generate friction if any one of three data points is missing: what was billed, what was actually collected, and which practitioner each procedure belongs to.

What really causes disputes: the fog, not the percentage

Disagreements are assumed to be about the rate. In reality they are nearly always about the raw material of the calculation. One practitioner believes he saw more patients than the tally shows. Another discovers that a discount granted by a colleague was deducted from shared revenue. A third finds that consultations paid in instalments were never attached to his name. Each of them is right from where he stands, because nobody is looking at the same source.

The cash book, the paper diary and the end-of-month spreadsheet keep that fog alive. They record amounts, rarely the practitioner concerned, almost never the gap between billed and collected. And it is precisely that gap that changes a split: billing 100 and collecting 70 does not produce the same share, and who bears the unpaid balance has to be settled in advance, not afterwards.

A disagreement about a percentage is settled in one meeting. A disagreement about the figures themselves is never settled.

The data to keep so the calculation is never contested

An uncontestable split does not require sophisticated cost accounting. It requires five pieces of information to be captured as they happen — not reconstructed from memory at the end of the month.

• The practitioner attached to each procedure, every time, including for a stand-in or a consultation taken over by a colleague.
• The amount billed and the amount collected, kept distinct, with the balance due clearly identified.
• Discounts and free visits, together with whoever granted them — otherwise they vanish into shared revenue and weigh on everybody.
• The type of procedure: consultation, technical act, follow-up, on-call. Many sharing rules depend on that distinction.
• The date of payment rather than the date of the consultation, whenever the split is based on money actually received.

Captured as they occur, these five items are enough to produce a tally nobody can seriously contest. Reconstructed after the fact, they are worth nothing — and that is always how a falling-out between partners begins.

Put the rule in writing, and review it once a year

A sharing rule should be written down, even between colleagues who get along. Not out of distrust, but because a written rule protects the relationship: it spares everyone from renegotiating each month what was agreed once. A few points deserve to be settled in black and white from the start.

• Who bears unpaid balances: the practice, the practitioner concerned, or both in defined proportions?
• How are exceptional discounts and patients seen free of charge handled?
• What exactly does the practice's share cover: premises, staff, consumables, software, communication?
• How are on-call duty, standby and covering for an absent colleague paid?
• On what date of the month the tally is drawn up, from which source, and who may consult it.

That last point is the most important, and the most often neglected. A split whose figures each practitioner can check for himself almost never needs defending. A split only the manager can see will be contested sooner or later, even if it is perfectly fair. Finally, it is healthy to revisit the agreement once a year: activity that doubles, a specialty that is added or a departure all change the original balance, and it is better to adjust calmly than to discover the tension at the end of a difficult month.

Where Uli fits in

This groundwork is exactly what Uli makes simple, without adding to reception's workload. Every procedure is attached to the practitioner who performed it; billing separates the amount charged, the discounts granted, the payment received and the balance due; and unpaid-invoice tracking keeps a record of what has not yet come in. The team schedule — services, on-call duty, leave — shows who was practising when; statistics give activity by practitioner and by period; the audit log keeps who entered what, and when. The sharing rule remains your decision: Uli supplies the material that makes it verifiable by everyone, month after month, in the same place as appointments, the patient record and SMS reminders.

Your data is hosted 100% in Algeria, AES-256 encrypted and transmitted over TLS 1.3. The trial is free for 14 days, with no bank card, and from 3,000 DZD/month afterwards — a full billing cycle, long enough to compare your usual tally with the one produced by tracking kept as you go.