Most physicians are not confrontational with peers, Smith adds. "You have to have a medical director who is willing to fight the good fight and tell a colleague, 'You might be a good doc but nothing in our electronic record is proving that, so you need to change your ways, and if we can't get there we need to reevaluate your contract.'"
It gets a little more complicated when discussing compensation. A new Medical Group Management Association survey found that annual stipends for the medical director role could range from $25,000 to $44,600 based on scope of responsibilities, time demands, and clinical specialty. In addition, the survey found that nearly half of the medical directors reported working less than six hours a week on directorship activities. Smith says he expects that will change as quality metrics become more sophisticated and play a greater role in determining compensation.
Smith notes that several factors go into determining medical director pay. "In my group, I look at our medical director and I say, 'What would you have made as a primary care doc in our practice?' He works two full days a week in this role. I say that is 'X' amount of money because you would have been in the office otherwise. In addition we say, 'How did you do based on the quality measures?' Then we decide 'Are we going to pay him above that?'"