When you have been reviewing physician employment agreements for nearly four decades, you tend to get a little jaded about the possibility of ever seeing reasonable compensation for physicians. Although I am continually preaching to the choir about the need for reasonable physician compensation, I rarely see something that gives me encouragement that physicians may someday be paid appropriately for everything they do.
However, recently I have reviewed several agreements titled along the lines of an “Individual Specialty Residency Program Agreement.” I find the existence of these agreements to be an encouraging sign. Physician employment agreements have traditionally heaped a generous portion of administrative duties on the physician without corresponding compensation. Teaching residents has always been “just part of the job” for physicians – even physicians who are compensated based on productivity.
These new agreements actually pay physicians for the hours they spend mentoring residents. Yes, you read that sentence correctly. Physicians are actually being paid for their part in training the next generation of physicians. I am sure that nobody reading this article will be shocked to learn that the pay is not magnificent. It is basically equivalent to the hourly rate a medical director receives. Still, I view this development as positive since it appears to recognize the fact that physicians are performing vital roles even if no superbill is generated from that activity.
Naturally, the agreements all have a maximum number of hours per year which will be compensated for mentoring, and the hours provided in the agreements are usually not nearly enough to cover all the hours that will be spent. As everyone expects, physicians will continue mentoring like they always have, whether they are being paid or not.
In my mind, the significance of the promulgation of these new agreements is not the amount of compensation paid or the limits on compensable time. These agreements involve paying physicians for activities that have always been considered part of their professional duties. This may be the tiniest recognition that physicians are more than wRVU machines. Recognizing the importance of training the next generation (and acknowledging that the expertise being imparted is valuable) seems like a step towards once again recognizing physicians as true professionals.
MGMA already produces benchmarks for call compensation and medical directorships. Are benchmarks forthcoming for mentoring duties? Probably not soon, but maybe in a few years?
Physicians, as professionals, are held to a high standard of performance. That has always been the case, and it always will be case. However, no other profession is expected to dedicate vast amounts of time in training the next generation of professionals while still being compensated based solely on productivity.
I am not by nature optimistic, particularly when considering the plight of physicians. Physicians are always willing to put their patients and the practicing of their profession above their own welfare. That makes physicians easy prey for administrators who focus on the bottom line. These agreements certainly do not signal the end of physicians being taken advantage of. However, I think it is possible that paying physicians for mentoring residents is a recognition of their professionalism, and maybe, just maybe, a small step toward fairer overall compensation for everything they do.
Dennis Hursh is a veteran attorney with over 40 years of experience in health law. He is founder, Physician Agreements Health Law, which offers a fixed fee review of physician employment agreements to protect physicians in one of the biggest transactions of their careers. He can also be reached on Facebook and LinkedIn.
