medical director comp reduction

[nexus73]

I'm facing a reduction in hourly compensation for medical director time. I was at $200/hour for several years, but hospital says market rate is actually $135 so sent new contract with lower rate. I'm at the point where I don't feel it's worth continuing for this amount, and I'd rather give up the headache, have my off time and evenings free from the calls to manage various issues that arise. However, I was curious if people could weigh in on their administrative time rates, hoping to get a sense of what is actually being paid out there. I'm a W2 employee on salary covering inpatient adult/consult service, with medical director hours paid over and above salary each month.

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[ObsequiousAplomb]

Lol, they claim that a 33% reduction in pay meets market demands? Lol. No amount of money would ever be worth the satisfaction of letting them fill that space themselves.

 

[comp1]

That seems like a weird setup. If you're salaried, you should be salaried. Sure, there might be extra pay for call, but I feel like paying hourly for administrative work is just...odd. That, if anything, should be paid at a flat annual rate. I'm just having trouble conceptualizing it. When we hire managers...we hire managers, as in this is built into the job and the pay. I mean honestly what I see more often (in the community, not with me personally) is a 1099 getting a flat $20k or something to do admin stuff for the year. I'm not sure that's a good deal, but your setup just seems particularly weird. What exactly are you doing for the $135 or $200/hour? Since you're on here asking instead of immediately telling them to take a hike suggests the job might have been a bit sweet? That said, generally, medical director effort still requires the MD, so it shouldn't be paid less than clinical time, but since you're salaried, you don't really know exactly what they are paying you for your clinical time... As the above poster said, this is a massive reduction...so what data specifically are they bringing to support it?

 

[littlefred]

I've been offered the same exact gig as the doc above, why is it so weird to you @comp1 ?

 

[comp1]

It is weird because admin responsibilities are 24/7. It doesn't break itself well into hourly chunks.

 

[TexasPhysician]

That isn’t market for a psychiatrist. I’ve had a job where I was literally paid to sit there without my phone. No phone, no sleeping, no clinical work, no admin work. Literally sitting and reading a book at my leisure for $160. I don’t leave my house or disrupt my day for $135/hr.

 

[nexus73]

The hourly pay structure I believe is chosen to minimize risk of kickback accusation. As in giving a cardiologist $100k to be medical director (wink wink) but they have no actual responsibilities other than to refer every patient they have to cardiac tests and caths to that hospital. If admin time is accounted for hourly with a brief description it at least appears work is being done for admin pay.

 

[forchinet121]

135/hr is an actual joke and is similar to resident pay..200 is absolute minimum

 

[Old&InTheWay]

135/hr is an actual joke and is similar to resident pay..200 is absolute minimum

Man, I wish I had gotten one of these $280k+/yr resident gigs. 🙄

 

[clozareal]

Man, I wish I had gotten one of these $280k+/yr resident gigs. 🙄

I think they meant moonlighting pay in residency

 

[finalpsychyear]

Don't be surprised if they say in a few years 135 is your new hourly market rate with the NP flood coming. The system is rigged. Work hard and get out. The game is a joke meant to keep you on the hamster wheel for life.

 

[psychma]

I have a master’s degree in counseling. I earn $135/hr. I’d say no.

 

[Merovinge]

Man, I wish I had gotten one of these $280k+/yr resident gigs. 🙄

I moonlighted for $140/hour almost 10 years ago as a fellow. I certainly wouldn't say $135/hour is standard for medical directorship, that seems very low to me.

 

[TheRightMedication]

I can't answer your question directly but I've decided to post only to agree, very strongly, with those above. 135 per hour is very, very low for a physician. Let alone for the admin headaches.

My goal is 300 per hour and there's nothing special about me or my area. As a solo practitioner, I don't have MBAs taking a cut.

 

[FlowRate]

Our organization reimburses administrative/leadership roles at the exact same hourly rate as your primary specialty role, although in our case the admin role comes with its own FTE and a concomitant clinical FTE reduction. As pointed out above, some weeks that additional admin FTE doesn't fully cover our admin duties but it's close enough most of the time. There has been some suggestion that full-time administrators be moved to an administrative salary scale especially for the higher-paid specialties.

 

[SmallBird]

There are different benchmarks used for medical director time, although it is apparent that whoever supplies hospitals with that data is skewing things to depress this reimbursement. It is very common for this to be something that gets reimbursed per hour, and I've never gotten paid as much for medical director time as clinical time. I have never seen a rate as low as $135/hour but I've heard benchmarks of $150-$175/hour which is also less than clinical work but I'm not sure it's helpful to be aghast about as clearly people are agreeing to do the work in that pay range.

 

[the5thelement]

Has the CEO of the organization also taken a 33% pay cut?

 

[Sushirolls]

Less than $180, probably not worth continuing for Psychiatric inpatient.
Medical directors hold extra liability that at times, requires additional liability insurance that is a separate policy. Costs more money, and could negative the financial benefits of being a med dir in some situations.

Let some one else fall on that sword.

Considering you have $200, let them know any reduction you won't agree to.

When the day comes no one else falls on the sword, you will be happy to resume, but now the market rates reflect $210 is the true number.

Anti-kickback stuff is mitigated by filling out time sheet cards that detail the work being done. Not really an issue.

 

[TexasPhysician]

Less than $180, probably not worth continuing for Psychiatric inpatient.
Medical directors hold extra liability that at times, requires additional liability insurance that is a separate policy. Costs more money, and could negative the financial benefits of being a med dir in some situations.

Let some one else fall on that sword.

Considering you have $200, let them know any reduction you won't agree to.

When the day comes no one else falls on the sword, you will be happy to resume, but now the market rates reflect $210 is the true number.

Anti-kickback stuff is mitigated by filling out time sheet cards that detail the work being done. Not really an issue.

Agreed.

I wouldn’t be interested in being medical director at $200, but if I was already there, I’d counter that with inflation, I’m now expecting $220/hr or whatever higher amount you wish. If unacceptable, Id gladly let someone else take the position.

It’s best to negotiate from a position of strength and be willing to walk. Next time, they’ll think twice about trying to reduce your rate.

 

[comp1]

I am so confused. What are people doing in this role that any of you bill for it in an hourly manner?

 

[deleted1158258]

Don't be surprised if they say in a few years 135 is your new hourly market rate with the NP flood coming. The system is rigged. Work hard and get out. The game is a joke meant to keep you on the hamster wheel for life.

Isn't there already an NP flood?

 

[Sushirolls]

I am so confused. What are people doing in this role that any of you bill for it in an hourly manner?

This is how many medical director positions work.
You get a time sheet.
You fill it in, and get paid.
Typically, they cap it and the majority of time you should hit those hours per month when you submit them.

Have a meeting? that counts.
Talk with nurse manager, that counts.
Review regulations for CMS online. That counts.
Meet with hospital CEO, CFO, that counts.
Read their emails, that counts. Email takes 5 min. You bill 15min, in 15 min increments.
Psych collegaue emails you complaining about call schedule, response by email, that's 15 min.
Making call schedule, that's XYZ time
Formal compliant lodged aginst nurse or colleague, need to review and see if merit that needs intervention, you bill it.
ED dept head, vents at you for not doing XYZ, you bill those meetings.
Chart reviews of the ARNPs or colleagues. You bill it.
Medical staff office wants you to sign Scat, you bill it.
Credentialling time from Med Staff office, need to review and sign off on all your colleagues, or pester them to do their stuff. Bill it.
Someone might get sued and risk management is pestering you, bill it.
Tour of unit for some random new mental health agency or referral source, you bill it.
Meetings in community with LEO or other stakeholders for improving mental health treatment/access/whatever, you bill it.
Colleague in the hall catches you, social catch up, but at the end, says, "Oh, are we ever going to get CME coverage for self study books?" Bill that.

The list goes on.

You bill it. You get paid. Don't hold back.
Cause you, ArE tHe FaLl GuY fOr WhEn ScAt GoEs SoUtH.