I am writing today and every Friday in May to begin a conversation about compensation in earnest. Please be an active participant in this process and take the opportunity to be informed with each post.

What are we expecting from compensation?  This is a question I have wrestled with since becoming a leader in academic medicine. Compensation should reward faculty productivity in a fair and transparent manner; an effective compensation mechanism will aid our department in recruiting and retaining the best and most creative faculty. A less obvious benefit is that a compensation model will require us to develop quantitative definitions of remunerated and unremunerated work that are necessary tools for negotiating with our health system and other payors.

Compensation has many components and the relative value of these varies from one individual to the next. Mentored advancement through a rigorous but fair pathway of academic rank, support for individual initiatives to advance our academic missions and work amongst the richest human and intellectual environments so far created for academic medicine (i.e. Johns Hopkins Medicine) represent major elements of compensation that bind us to our work and our colleagues, divisions, department, school, health system and university. I will work with departmental and other leaders to keep these pieces robust and relevant. Money, however, is also a major aspect of compensation. Monetary compensation includes institutional matching funds for tax deferred savings, fringe and tuition benefits in addition to base salary and incentive payments, though I appreciate salary and incentives are the core components of financial compensation.

From the time I set foot in Baltimore, I have discussed plans to build and implement a fair, transparent, productivity-based compensation model for the Department of Medicine, and I have set a goal to operationalize the model by July 2016. We are about to conclude a relatively silent modeling and research phase that was necessary to lay the groundwork for a department-wide compensation plan. Thank you to the entire administrative team who has gotten us to this point. Now there is much to be done, including communication, education and building computational and web-based tools that will allow our faculty to follow their progress in real time.

No one embarks on a career in academic medicine as a way to become wealthy, so it is reasonable to ask if a financial compensation model is really necessary or if it is likely to do more harm than good. For example, a compensation plan might intentionally or unintentionally threaten important but unremunerated activities that are essential for the academic medicine enterprise. We all engage in unremunerated activities, such as teaching, committee work, scholarship and even some types of clinical care; there is little doubt that the loss of these activities would harm our system.

My view is that a comprehensive and transparent model built on principles is necessary for our department and that this model will need to comprehend, quantify and honor essential activities that contribute to our missions, whether or not they generate revenue.  This concept of protecting time to participate in these unremunerated activities will be further described in the coming week’s posts.

I am excited about the next phase of this project. We are about to embark on an important effort to better unify our department by providing a comprehensive, fair and transparent system for salary. Managing our work through such a system will provide direct benefits to faculty, our department, school and health system. By improved management of our revenue streams we may have better opportunities to meet the expenses of our missions. In the end, I believe, a system of transparent faculty, productivity-based salaries will let us grow along a constructive and forward-looking path that will lead us to be fit for a future of discovery and innovation, education and patient care.

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Please check back next week (5/8) for Part 2: Salary Equity Analysis

 

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