A transparent formula instead of subjective decisions
Single metric
A Chaika clinic CEO’s income is determined by an open formula that they can calculate themselves — at any time, without approvals or waiting.
The formula is tied to a single metric: Distributable Profit (DP) — the clinic’s profit available for distribution. The better the clinic’s economics, the higher the CEO’s income. There is no cap.
The principle: asymmetric partnership
The CEO participates in the clinic’s profit without limits. At the same time, they bear no financial responsibility for losses. If the clinic is in the red, the bonus is zero — but the fixed salary is paid in full. Negative bonuses do not exist. Losses from prior months are never deducted from future bonuses.
We call this partnership asymmetry. The CEO thinks like an entrepreneur but does not carry entrepreneurial risk. This is a deliberate choice.
What the income consists of two parts
Fixed salary is paid monthly, regardless of the clinic’s performance. It is a guaranteed base — the stability that allows the CEO to focus on growth.
Variable bonus is calculated monthly from the clinic’s profit. Not quarterly, not annually — every month. The CEO sees the results of their decisions in near real time.
How clinic profit is calculated
The profit on which the bonus is based is Distributable Profit (DP) — a metric that reflects the clinic’s true economic result after all costs are deducted. It is calculated in five steps.
First
We take each doctor’s revenue and subtract direct costs — consumables, materials. The result is Doctor NPR (Net Professional Revenue) — the net revenue generated by a specific doctor.
Second
We add up Doctor NPR for all doctors within a practice and subtract shared practice costs — equipment and the like. The result is Practice Margin — the practice’s profit. This is what the Practice Leader distributes among the team.
Third
A portion of Practice Margin is retained by the clinic — this is the Clinic Share. The rest goes to doctor salaries, assistants, and bonuses.
For example, in Moscow clinics the split is 43% to 57%.
Fourth
From the Clinic Share we subtract fixed costs — rent, administration, HR, equipment. The result is Clinic Operating Profit.
Fifth
We subtract the Platform Fee — the holding company’s fee for the brand, the IT platform, and the organisational infrastructure for patient engagement. What remains is DP.
Each of these steps is transparent and verifiable. The CEO sees all the numbers and can influence every one of them.
Progressive bonus scale
The bonus is not calculated at a flat rate but on a progressive scale — like income tax brackets. Each successive tranche of profit is subject to a higher rate. For example, in
Moscow clinics the scale is as follows: — first €30,000 of DP — 4% — from €30,000 to €70,000 — 6% — from €70,000 to €120,000 — 8% — above €120,000 — 10%
The rates increase only on the next portion of profit, not on the entire amount. This means every additional euro of DP always increases the bonus — there are no ceilings and no points where growth stops being rewarded.
This structure is particularly advantageous for CEOs of large and growing clinics: the higher the result, the higher the percentage on each incremental euro.
Worked example
Consider a clinic with DP of €100,000 per month and a CEO’s fixed salary of €5,000. All figures in this example are in euros.
The bonus is calculated in tiers: €30,000 × 4% = €1,200, the next €40,000 × 6% = €2,400, the remaining €30,000 × 8% = €2,400.
Total bonus:€6,000.Of this amount, 70% is paid immediately: €6,000 × 70% = €4,200. The remaining 30% (€1,800) goes into the accumulation fund.
The CEO receives per month: €5,000 + €4,200 = €9,200.
The figures are illustrative and not tied to any specific clinic. All compensation amounts are stated before income tax and include social contributions — this is the total cost to the company.
Accumulation fund
70% of the accrued bonus is paid out immediately. The remaining 30% goes into the CEO’s individual accumulation fund.
The fund is paid out in two stages: half after 12 months, the other half after 24 months. This means that any given month’s bonus is distributed over time: 70% now, 15% after one year, 15% after two years.
This creates a long-term link to performance. A CEO who builds sustainable clinic economics accumulates a substantial fund — an economic equivalent of equity, without any legal transfer of shares.
Growth bonus
Separate from the monthly bonus, there is an annual Growth Kicker. If the clinic’s annual DP has grown by more than 10% year on year, the CEO receives an additional 2% of the absolute increase.
This mechanism rewards not just high profit, but its trajectory — the CEO’s ability to find and realise opportunities for growth.
Multiple roles
In the medical business, a clinic CEO often wears several hats — running the clinic, heading one of its practices, seeing patients. At Chaika, all income streams from combined roles are independent of one another.
Income as clinic CEO — fixed salary plus DP-based bonus — is determined by the system described here. Income as Practice Leader — a share of Practice Margin — is accrued on the same terms as for any other Practice Leader. Income as a practising doctor — a progressive scale based on personal Doctor NPR — is accrued under standard physician terms.
No stream reduces or limits another. A CEO who sees patients and leads a practice receives all three forms of compensation in full.
Managing two clinics
When one CEO runs two clinics, the fixed salary is increased with a multiplier (not doubled — a coefficient reflecting the additional complexity).
The bonus is calculated separately for each clinic and then combined. A loss at one clinic is not deducted from the bonus earned at the other. The CEO does not lose motivation to develop a profitable clinic because of difficulties at the second one.
Why we publish this
We consider transparency a competitive advantage. When a candidate for a clinic CEO position understands the rules before starting work, it changes the quality of the relationship. No hidden terms. No “we’ll discuss it at year-end.” There is a formula, a calculator, and full access to the data that determines the outcome.
🇷🇺 & 🇬🇪
We are currently looking for CEOs for a clinic in Moscow and a clinic in Tbilisi