I recently reviewed an agreement that involved paying physicians for resident supervision. I think this is a very encouraging sign, and am hopeful we can spread the news and make this a trend.
A Hospital is Paying Physicians for Resident Supervision
That is not a typo, I have reviewed an agreement recently called an “Individual Specialty Residency Program Agreement.” It was presented to a recruited physician as a sweetener to the physician’s normal compensation.
I want to emphasize that this physician was not being hired as the “Designated Institutional Official” (DIO) for ACGME accreditation or assistant to the DIO, Education Coordinator for ACGME, or in any other role required for ACGME accreditation. Although the physician was deemed to be “Core Faculty,” the roles assigned were not different from what I typically see required as part of the standard physician employment contract.
This physician was “merely” one of the physicians in the department who (like all the other physicians in the department) was tasked with supervising and teaching residents. The hospital was not an academic institution.
Why Paying Physicians for Resident Supervision is a Big Deal
I have been doing physician contract review for several decades, and I have seen how outlier behavior can become standard. One of the first blog posts I did had a somewhat breathless headline of “OIG gives OK to hospital paying for call coverage.” This was big news in 2009 (I was a child prodigy, trust me). At that time physicians were given unlimited call coverage requirements as just “part of the job.” Hospitals would blithely inform physicians that they could not be compensated for call coverage, because that would trigger the fraud and abuse laws. Now, of course, it is routine to pay call coverage compensation, and the Medical Group Management Association (“MGMA”) provides benchmarks for call compensation. Reviewing the payment for call coverage is part of any good MGMA compensation analysis.
I am not an optimist by nature, but I can’t help but wonder if paying physicians for resident supervision will also become the norm, so that in 15 years or so this post will be viewed as a quaint reminder of the bad old days.
What's the Catch in Paying Physicians for Resident Supervision?
There really isn’t a catch, per se, but the agreement limited compensation to 96 hours per year. That works out to eight hours per month – hardly all the time that will be spent in supervising residents.
The agreement required “documentation” of the hours, but it wasn’t particularly specific. I assume that a signed piece of paper that says “morning rounds with residents 8/1/24 to 8/8/24” would suffice.
The compensation wasn’t spectacular – it was roughly the same hourly rate as that paid for medical director services, and was capped at less than $22,000 per year.
Why Care About Paying Physicians for Resident Supervision?
Do you supervise residents? (I’m guessing that you do – most physicians have some involvement in training the next generation of medicine). If you do, are you being paid for supervising residents? (I’m guessing you are not paid – most physicians are not). Here is the million dollar question: “Why aren’t you being paid for supervising residents?”
I now routinely ask for compensation for resident supervision when doing a physician contract review. I think we need to make that a standard request in physician employment agreement negotiation. We can’t expect every employer to immediately begin paying physicians for resident supervision. But by chipping away and always keeping the issue alive, we can hopefully start to normalize compensation for this part of your job.
What’s next, paying physicians for charting? Stay tuned!
If you have an agreement you would like us to review, you can start your review here. We can also provide a free consultation to talk about how we can help.
