As an emergency medicine (EM) practice management consultant I”m frequently asked “How can we determine what’s fair to pay for physician administrative duties?”  It’s an emotional subject in every group because it involves the discussion of each member’s relative value to the business enterprise side of the practice.

An entitlement culture is one which says, “you owe me” because of who I am or what status group I belong to. While some have argued that such a mentality has been on display in the Occupy Wall Street movement – young people believing that they are “owed” a job because a small percentage of the population earns a lot of money – they are certainly not alone.

Delivering a top quality patient experience is “a mountain without a top.”
Is it time for your EM group to take the first step up?

Part IV, In which we look at an example group and provide some benchmarks for guiding your own group’s discussion of administrative compensation.

Part II: Democratic groups must define their core values, clarify the owner’s obligations to the group, and put in place a system of accountability.

No question generates more angst or consumes more discussion for a democratic emergency medicine (EM) group than how much to pay for practice leadership and administration. In the typical democratic EM group, every dollar of proposed leadership or practice management expenditure is challenged and every dollar of approved expenditure is resented to one degree or another.

Emergency physicians have historically been ambivalent about inappropriate ED utilization. We deplore it but are reluctant to address it because we believe that there may be no alternative for these patients, that excessive risk or the threat of an EMTALA violation are prohibitive, or that it may cost us practice revenue. But failing to address an issue of critical importance to our hospital customer is the first step on the path toward losing the contract.