CAS 2012 Preview: Compensating Clinical Educators

By Scott P. Stringer

Standing on the stage early in my career presenting a new compensation plan to the assembled faculty at the University of Florida College of Medicine, I noticed from the corner of my eye that the dean, who was on stage with me, seemed to be getting farther and farther away almost to the point of being off the stage altogether as the faculty questions and comments grew somewhat hostile. I immediately realized that leading a faculty compensation plan committee was a much more dangerous job than I imagined; and that the dean was wiser than I.  

The real lesson I learned, though, was how emotionally charged compensation discussions can be and how many different views there are about what is fair and proper. Compensation is an important way in which we view our worth to an institution, a superior, and even ourselves, creating discussions that are more emotional than rational. My presentation at UFCM came at the end of a year of intensive work by a seemingly representative committee. We used faculty surveys and small group meetings to gain broad input and support. We drew from work from a variety of sister institutions to improve our plan. Yet, in the end, a new compensation plan proved threatening to many.

I have spent a great deal of time since then working with faculty compensation and seeking to better understand the “why” behind the “what “ of compensation plans. Despite my hostile audience, the plan was implemented at UFCM, and I led the committee through a revision a couple of years later. The framework and principles of the plan remained in place until I left to become a department chair at the University of Mississippi School of Medicine. I remained involved in compensation plan development there by creating a new departmental plan; later, as an associate vice chancellor for clinical affairs, instituted a new contribution-based compensation plan across the entire clinical enterprise.

The issue of compensating clinician educators is critical due to the growing physician shortage and continued downward cost pressures, making it increasingly difficult to recruit and retain the talent necessary to serve our students and patients. This demands that we create compensation plans that function well in the era of the war for talent.

There is a large body of literature on compensation philosophy and strategies. Unfortunately, it often conflicts. Compensation plans are necessary to provide salary and benefits at a level that will recruit and retain the individuals necessary to accomplish the mission of the organization. In addition, the plans should be equitable, easy to understand and administer, and timely. We seek to design plans that align incentives, promote desired behaviors, and link seamlessly to promotion and tenure policies. This is a challenge even in a simple system, but in an academic medical center with multiple and diverse missions in a setting that strongly values individuality, creating a plan that fulfills all of these goals can be complex and contentious.

In our small group discussion next Saturday at the CAS 2012 meeting in Santa Fe, we will review the goals and principles of faculty compensation plans.  Representative plans will be presented, followed by a detailed review of the plan currently in place at the University of Mississippi. We will critically analyze the implementation of this plan along with its relationship to institutional funds flow. We will explore the contentious idea that a compensation plan should do nothing more than set compensation at the minimal level at which talented individuals no longer think about it. I encourage all participants to come prepared to share and discuss their compensation plan best practices. This exchange of ideas among peers is the most rewarding aspect of the CAS meetings.

—Scott P. Stringer, MD, MS is Professor and Chairman of the Department of Otolaryngology and Communicative Sciences at the University of Mississippi Medical Center.  He has been at the University of Mississippi Medical Center since 2001. He can be reached at sstringer@umc.edu.

 

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