The sort of weather we’ve experienced lately prompts contemplation. I thought we were in the warm South until last week. What is all this “polar vortex” stuff about?
Since I can’t seem to figure out the weather, I have been thinking about the work that is being done to implement our new faculty compensation plan. The objective for this work is to fairly measure clinical and educational efforts with logical parameters, then link compensation with value.
We have been through one cycle of this with the faculty. I am forecasting it will take several cycles for us to become completely familiar with all of the nuances.
To facilitate that process, I have appointed a Compensation Advisory Committee chaired by Senior Associate Dean for Academic Affairs Dr. Elizabeth Baxley. The team is broadly constituted to bring a variety of perspectives to the work. Despite all the support and thought that went into creating the compensation plan, implementation still has been a significant challenge.
A compensation plan is not just a data-driven exercise. “Culture” also comes into play. Compensation is clearly linked to money and pay, but that is not all.
When I was in Syracuse, I helped develop and implement a physician compensation plan. It was a culture-changing exercise.
The picture illustrates the relatively thick book titled, “Physician Compensation Plans – State-of-the-Art Strategies,” by Bruce A. Johnson, JD, MPA, and Deborah Walker Keegan, PhD, FACMPE. It is published by the Medical Group Management Association.
I bought this book in Syracuse, and even though it is a few years old, it is still relevant. The book describes all the dynamics and complexities likely to occur with any rationally-conceived compensation plan.
To quote a couple of sentences from the introduction:
“Why would medical directors or practice executives decide to champion a new compensation plan for their medical practice? Just the mere thought of tackling the complex, emotionally laden, legal minefield of physician compensation puts fear in the hearts and minds of otherwise rational beings. It is fully recognized that the process of changing a physician compensation plan may not be top on the list of career-enhancing events.”
Now that is encouraging!
But having a well understood and implemented compensation plan is essential in the orderly execution of our mission. It goes well beyond the satisfaction of individuals. This is a hugely important cultural transformation for us all.
Most of us speak about transformation in the third person. The reality is that the landscape we’ve become accustomed to is changing all around us, and we must individually accept this in order to prepare ourselves for our shared future.
We must personally adapt.
Which leads me to the concepts of Authority, Autonomy and Accountability.
Each of us “wears a hat” in the organizational structure. It is the authority vested in us by the organization. Similarly, as professionals we wield a significant amount of autonomy in our practices. Likewise and inevitably, each of us is accountable. We may point defensively to someone else, but in reality, in reflection, who is that someone?
This is where individual and personal introspection in these last (hopefully) dark days of winter may bear fruit.
We have full authority to support our mission, individually and collectively. We have autonomy that is evidenced by the faithful execution of our medical profession. We are accountable for the financial viability of our school. We are fully accountable for our individual actions.
Because excellence is our only acceptable standard, we are accountable for activities across the whole spectrum of work – not just the clinical activities. We champion graduate medical education and the advancement of science itself. All of this, of course, is intimately linked with our own personal desires for achievement and success.
Obviously, most of us balance these three principles in very practical and acceptable ways. The exciting challenge is when we all commit to converge our energies and actions for the most superlative implementation of winning strategies. That is how we can remain competitive in a volatile and complex medical world!
The weather has clearly complicated all of our lives, but it is nothing compared to the hugely transformative changes we have purposefully implemented. I also realize that “change happens at the speed of trust.”
As spring arrives, I am confident we will enjoy a renewed sense of commitment and all of the courage necessary to embrace a bright future of opportunity.
I hope to see you soon. Stay warm! And dry!