Career and Life Planning Guidebook for Medical Residents

and continues to createvalue-based payment models and rural health initiatives, all of which eventually impact howphysicians receive compensationwhether through direct employment relationships or through practice reimbursement for professional services. Medical administrative/physician leadership services – Some physicians with appropriate leadership skills may be asked to provide medical administrative or physician leadership services within an organization. Roles are typically individually assigned, and not available to all physicians. An example of medical administrative responsibilities might include designation as a medical director of a hospital department or service line. Examples of physician leadership responsibilities might include designation as a medical group president or a service line/regional executive. Such roles are often part time, however some may be full time as the role requires. As market players in the healthcare arena continue to evolve, physicians are seen as integral partners contributing to strategy, growth, development, and culture. For example, as health systems increase in size, there has been a corresponding increase in the prevalence of “regional” and “system-wide” medical administrative and physician leadership designations. Similar to call coverage, leadership roles are fact specific and do vary across different facilities and different markets. A title of “medical director” means only what that organization has defined the role to encompass. Job descriptions and scope of responsibilitywill vary from role to role, even within the same organization. Payment to physicians for such services typically requires detailed time documentation submission and approval. Before committing to these additional services, make sure to understand the following: What are the position qualifications? What are the expected duties and to whom do I report? What is the expected time commitment? Is my clinical practice schedule going to be modified to allow for this time commitment? What are the time reporting requirements? Howwill my performance be evaluated? How will I be compensated for these services (stipend; hourly)? Is there any incentive linked to my performance in this role? Are the compensation terms fair market value and commercially reasonable? Medical administrative services are typically valued lower than clinical services as the value to an organization for physician leadership is economically different than that ofdirect patient care. Historicallyyou might have observed hospitals and health systems valuing all medical administrative services at a flat rate (e.g., $125-150 per-hour) regardless of the position and the physician’s clinical specialty. That approach is disappearing as hospitals and health systems have had to face the reality that a neurosurgeon’s and a family physician’s time is inherently valued differently in the market. But don’t expect full opportunity cost based on your clinical rate of pay to apply to medical administrative services. The trend is that “clinical” and “non-clinical” rates are coming closer together, but each service has to stand alone from a valuation perspective. Other opportunities – Depending on the practice setting, you may be asked to participate in research or teaching (e.g., residency programs). Compensation for these services will typically be a function of the time commitment on an hourly rate basis. Youmay also find additional compensation opportunities arising through third-party, value-based incentive programs such as gain sharing, population health, shared savings, and quality improvement programs. Depending on the nature and funds-flow of these programs, there may be predetermined, pass-through percentages or other distribution methodology applied. Physician Compensation 229 WWW.PHYSICIANCAREERPLANNING.COM