My initial reaction was to question the rational behind the decision to pay some and not all. In my opinion, this is not sustainable and should be abolished totally. I think its ok to fairly compensate physician based on productivity and quality of care. So its better to have a general language in the contract, if these are employed physicians, stating clearly the expectations of their clinical duties and responsibilities. Adding extra pay for calls may only complicate issues, so if call is included in quality/productivity/wRVU clause, it may make the difference. So in summary, I think constituting a compensation committee with representation from the different specialties to discuss and decide on this matter will be a good starting point. Good Luck.
My organization/Medical Group recently constituted a Contract and Compensation Steering Committee to address this common but complex issue in healthcare industry. We plan to standardize the compensation model that is fair yet allow for productivity and quality and safe patient care. This committee is made up of about 90% physicians from different specialty background. The initial proposal is to have a common/standardized general percentage base pay that correspond to certain percentile on MGMA national average and per specialty and per years of experience. Then some percentage were allocate for wRVU and others for quality metrics. This will hopefully create internal competition while giving the medical group a competitive advantage as it relates to hiring and retention of providers. It is tough and a constantly moving target.
This is the world I live right now. I truly commend you for all the fantastic program you have implemented to make this center a medical home for patients. I wonder, however, if you have people from the community as liaisons for some of your program that address social determinants of health. People/patients will feel more relaxed and comfortable in familial environment, this can be bolstered with familial members from the community incorporated into your program and serving as champions of those programs. From the organizational stand point, I think a deliberate intensive marketing strategy should help to uplift the imagery and the “perception” of the center, this may include some rebranding and upgraded mission statement.
As you may know, “dyad leadership structure” is a social pull for physician migration to a health system and most organizations now adopt this leadership structure as a means of attracting physicians and partnering with them. Personally, I was a Care Division Medical Director in a Dyad partnership with an Administrative Director for our division. We went through a structured once a month Co-Leadership Class for one year where different leadership tools were provided and we were made to think through divisional projects or answer burning questions together during these classes and when we ran into a road block of who should make the call, we got a coach to help us navigate. Bottom line, you have to define the roles of the physician and the administrator abinitio. For my division, I led all clinical decision making process including formulating policies, protocols and procedures, ensuring quality and safe medical care for our patients and my dyad partner runs the day-to-day administrative process and non-clinical patients’ complaints/.concerns. We conduct interviews together but my partner decides on non-clinical staff, I decide on clinical staff.
It is always a challenge to blend different cultures together or merge organizations with different vision and mission. This will require deliberate attempt at “Behavioral and Cultural Change” in the entire new organization. For change to truly be effective, a leader must know how to effectively communicate the benefits, minimize the barriers and describe the processes. Learn from your peers as they share approaches that were successful and those that impeded the change process. I believe there are areas of opportunity to blend in the parent organization and area of developmental changes in the newly acquired entities, overall, there should be a new and formidable culture and not one dominating others. This will require a painfully slow process but achievable with consistency and focus on the common goal/vision.