One of the larger challenges that US healthcare faces is that it is a system largely run by non-clinical administrators, with little to no input from the patients and clinicians at the heart of the clinical experience. As a non-clinical administrator-turned-entrepreneur, I firmly believe that the business skills non-clinical leaders bring to the table are invaluable, but that to create meaningful change in a healthcare organization, clinicians have to be part of the team that designs the change. 

Here’s where it gets sticky. Creating change in healthcare takes time, and meetings, and data, and more meetings. (All things that clinicians have either far too little of, or far too much of….but that’s a topic for another day.) The end result is that so often clinicians are nominated to a committee and are simply unable to dedicate more time in their week to an administrative responsibility. 

Rick Evans, the CXO at New York-Presbyterian, wrote recently about the success of their patient experience team. Two physicians were hired as the medical directors for patient experience; both are now leading projects to improve the patient experience, and engaging and advising in a meaningful and sustainable way. One critical step that New York-Presbyterian took in the hiring process was to enable both physicians to dedicate their time to the committee without compromising their other duties by building the medical directorship time into the physicians’ compensation. 

Compensating physicians for active engagement in change initiatives enables them to fully engage, and the ROI for such an investment is enormous in the context of creating a better patient experience, more efficient workflows, and better patient outcomes. Compensation for administrative leadership can be allocated in a number of ways:

• Buying down time from the physician’s clinical time allocation (fraction of FTE)
• Annual flat rate bonus
• Hourly compensation for time spent
• Variable bonus structure based on critical success factors

Physician engagement in change initiatives is often undervalued, but core to the success of healthcare institutions in a competitive market and challenging fiscal environment.