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Medicine (and Compensation) Matters: Spring 2016 Update

I am writing to update you on the progress of our compensation model.  On April 26, our model was presented and approved by the School of Medicine Compensation Committee. This committee was formed in response to the dean’s mandate that all departments implement a compensation model available as a written document by July 1, 2016. The committee representatives assigned to evaluate and present our model completed a questionnaire intended to interrogate aspects of transparency, equity and recognition of the tripartite mission. This questionnaire, the compensation model narrative and the PowerPoint presentation for the compensation committee will be available to all DOM faculty by an emailed link.

We began the quest to develop a comprehensive compensation model last year, based on core, guiding principles:

  • Transparency
  • Equity
  • Respect and consideration for all missions
  • Incentive pay for highly productive faculty
  • Recognition that certain important effort is not financially remunerated

Last year, as a preamble to developing a compensation model for our department, I asked Dr. Diane Becker to lead a team to analyze our salary data. This analysis was a necessary first step to eliminating potential barriers to pay equity. We found that for the ~100 faculty who lacked a clinical license and were exclusively or mostly involved in research that there were no salary differences between women and men nor between UIM and majority faculty. In contrast, for the ~500 faculty with a clinical practice women faculty were paid less than men, but there were no differences between UIM and majority faculty by specialty. Sherita Golden, Amanda VanderZyl and I met with each division director and division administrator to review salary on a faculty-by-faculty basis, and in some cases recommended salary adjustments. We did not detect systematic pay inequity for women or UIM faculty after subspecialty, rank/years in rank and RVU productivity were considered.  However, we did determine that lower pay for women was due to fewer women being professors and in paid leadership positions. I am committed to increasing the number of women and UIM faculty who are professors and leaders. As part of this process, we successfully appealed to the SOM to remedy the fixed components of salary (i.e.  A + B) for our faculty that were less than 25th percentile for their subspecialty and rank over the next year.

It is important to note that fixed compensation (i.e. A + B) is not the same as total compensation (i.e. A + B + C) because total compensation includes a bonus (C) component. This component will be trialed for the first time across our department as a productivity incentive. In order to further our goal of enhanced transparency, we have made fixed compensation and total compensation data tables available (click for tables). These tables show national data benchmarked from the AAMC. As a department, our salary benchmarks will remain below the 50th percentile for total compensation because our revenue portfolio is far more dependent on extramural funding compared to almost all other academic departments of medicine. The extraordinary environment for scholarship is what attracts so many outstanding people to Hopkins, but also creates an obstacle to achieving high salaries, which can only be supported by higher levels of clinical activity.

In order to start the model, we formed a DOM compensation committee with subcommittees for clinical, research and educational missions, which have met throughout the last year to provide feedback in building our model. We very recently developed a ‘portal’ so each faculty could review their personal revenue and effort, and soon salary information will be available to each faculty for cohort comparison; this information is intended to improve transparency and provide an objective framework for salary redress.

I am pleased with the result of this process. As you review and consider our model, please be aware that it is ‘organic,’ by which I mean the details, but not the principles, will change with experience and circumstance. Please also note that for divisions with existing incentive plans we anticipate a several year period to align these to our new departmental model.

 What the model will do:

  • Provide a transparent incentive plan for all faculty
  • Reward productivity
  • Acknowledge and provide credit for previously unremunerated effort
  • Allow faculty to track their progress online
  • Act as a quantitative tool for negotiating with payers and the health system

What the model won’t do:

  • Directly create revenue
  • Suspend market realities that drive different salaries based on subspecialty and work assignments

Mark Anderson