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
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.
Four common pitfalls for democratic EM physician groups, and the strategies you’ll need to survive and keep your contract.