Is relinquishing medical directorship leverage to get a raise?

[coroner]

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I am a hospital-based employee of a health care system. And I'm medical director at 3 small community hospitals. Granted they are low volume/small but, still categorized as CLIA lab high complexity and have AP specimens with the rare frozen sections and of course ample CP testing. I am getting 1K/mo. for 2 out of 3 hospitals (2K total/mo.) and not even getting paid for the 3rd.

I would like to be bumped up to double for all 3 hospitals: 2K x 3 hospitals = 6K/mo. total. The hospital said they would "look into it".

I am practicing solo and the closest hospital in the system is 1.5 hours away with 2 pathologists. One is maxed out on his medical directorships and the other expressed he is not interested in doing the medical directorships in the past.

If I don't get the raise I am looking for and cease my medical director role; but want to stay on as a staff pathologist, would the hospital to be forced to cave in and give me the raise? As mentioned, I think my leverage is staffing shortage. They have no one available on staff who is able or willing to accept it and recruiting / interviewing / credentialing a new pathologist takes months. There are 3.0 of us currently, and ideally the hospital wants 4.0 - 5.0 total pathologists.

Legally, lab tests cannot be performed without an active medical director as that is sanctionable by CLIA.
What can the hospital do if I don't get my raise and say, "I'm finished being medical director but still willing to stay on staff?"

 

[SunBakedTrash]

I would say “probably.” Giving you a few extra thousand seems like a small price to pay to keep the machine running. The “we’ll see” is a lot more reassuring than the “lol. lmao” that I received a few years ago in a similar situation.

 

[Granular]

I think $2K a month for being a hospital lab CLIA director (esp. if it is high complexity) is not unreasonable. But rather than the use of an ultimatum, you should show/explain your contribution to the lab operation (taking all the legal responsibility, signing off on everything, including corrective actions, proficiency testing, quality management plans, as well as troubleshooting, responding to complaints, etc.). If the lab makes $X million per year, your directorship is very little compensation compared to the risk and responsibility you take on to help them make that money. Also, you could tell them that you will oversee expanding their in-house test menu to reduce send outs, leading to more revenue. Or bring up the raise next time they want to expand the test menu, or when preparing for the next accreditation inspection.
IMO, $2K per month is in line with what I see advertised by the lab companies that connect directors to labs that need a director. Colleagues who have served as lab directors (for a side gig) have typically asked for at least that much.

 

[coroner]

Thanks for the responses. Yeah, I will try to play nice...but up to a certain point. As you mentioned going from 1K to 2K for each hospital is not breaking the bank for them. If they don't budge the current 24K/yr is not worth my time and effort.

 

[KeratinPearls]

It’s hard to find a pathologist nowadays. At least a good one. My friend told me his group was looking for a pathologist for one year and he was 1 hour from a large city. If you are in the middle of nowhere even more leverage for you.

 

[HeyDalaron]

Make it 3k a month each

 

[coroner]

Make it 3k a month each

I would like it!

 

[HeyDalaron]

I would like it!

What's stopping you from leading with that?

 

[Alteran]

I would actually approach it from a different angle. If you are getting AP business (or other business) from these sites, then you have to be paid market rate for these directorships. Otherwise, were an IG to look into it, either no payment or way below market value payment on part of the hospital could be construed as a kickback - which is of course not good.

So while the previously mentioned reasons are good, there is also a legal/compliance aspect to this.

 

[coroner]

What's stopping you from leading with that?

The hospital is stingy. My most recent meeting with them was with the VP and a "bean counter" who literally brought a calculator to the meeting and was punching away to figure out what my RVU's should be.

I would actually approach it from a different angle. If you are getting AP business (or other business) from these sites, then you have to be paid market rate for these directorships. Otherwise, were an IG to look into it, either no payment or way below market value payment on part of the hospital could be construed as a kickback - which is of course not good.

So while the previously mentioned reasons are good, there is also a legal/compliance aspect to this.

All of the hospitals do have AP but only 1 out of 3 has a pathologist on-site daily. I physically work in 1 hospital. The other 2, I drive to once per month. I wish they were spooked by an IG sanctioning them, but they are probably oblivious...

Thanks for the responses. Much appreciated!

 

[Med Director New England]

I am a hospital-based employee of a health care system. And I'm medical director at 3 small community hospitals. Granted they are low volume/small but, still categorized as CLIA lab high complexity and have AP specimens with the rare frozen sections and of course ample CP testing. I am getting 1K/mo. for 2 out of 3 hospitals (2K total/mo.) and not even getting paid for the 3rd.

I would like to be bumped up to double for all 3 hospitals: 2K x 3 hospitals = 6K/mo. total. The hospital said they would "look into it".

I am practicing solo and the closest hospital in the system is 1.5 hours away with 2 pathologists. One is maxed out on his medical directorships and the other expressed he is not interested in doing the medical directorships in the past.

If I don't get the raise I am looking for and cease my medical director role; but want to stay on as a staff pathologist, would the hospital to be forced to cave in and give me the raise? As mentioned, I think my leverage is staffing shortage. They have no one available on staff who is able or willing to accept it and recruiting / interviewing / credentialing a new pathologist takes months. There are 3.0 of us currently, and ideally the hospital wants 4.0 - 5.0 total pathologists.

Legally, lab tests cannot be performed without an active medical director as that is sanctionable by CLIA.
What can the hospital do if I don't get my raise and say, "I'm finished being medical director but still willing to stay on staff?"

It would depend on a lot of factors - test volume, complexity, # of beds in the hospitals your labs support, level of acuity of patient in these beds….many things.

That said - it sounds low.
How much time do you spend / week total all in on lab coverage ?

Also it sounds like the system would be completely screwed if you left.

What is your total comp - if you don’t mind me asking. Should exceed 400K and include 6-8 weeks vacation imo

 

[coroner]

It would depend on a lot of factors - test volume, complexity, # of beds in the hospitals your labs support, level of acuity of patient in these beds….many things.

That said - it sounds low.
How much time do you spend / week total all in on lab coverage ?

Also it sounds like the system would be completely screwed if you left.

What is your total comp - if you don’t mind me asking. Should exceed 400K and include 6-8 weeks vacation imo

Sent you a pm