The Medical Group Management Association's (MGMA's) Medical Directorship/On Call Compensation Survey: 2009 Report Based on 2008 Data found that hospital compensation provided to independent physicians serving as hospital medical directors was substantially more than when hospitals pay an employed physician for the position, according to an MGMA news release.

The study may raise serious business and legal issues, according to Scott Becker, JD, CPA, of McGuireWoods. "A key issue, for example, is whether the survey provides an inference that hospitals pay greater than fair value to independent medical directors and, if so, why do they do so," he says. "For example, do hospitals pay more to independent medical directors in influence referrals? Further, do hospitals use call coverage and medical director agreement in lieu of retention and recruitment agreements which are heavily restricted under the Stark Act?

"Or, in contrast, do hospitals simply have to pay more to independent physicians because affiliated employed physicians are essentially required to perform the services as part of their overall duties," Mr. Becker says.

The survey showed that nonsurgical specialists in nonhospital-owned practices received $27,400 more annually than their counterparts in hospital-owned practices, according to the release. Compensation varied greatly across specialties, with geriatricians earning the most at $172,121 annually.

According to the release, physician education duties increased primary care compensation by 82 percent, and surgical and nonsurgical specialists reported compensation increases above 100 percent.

The survey found that primary care directors with recruitment responsibilities showed the greatest variation in annualized compensation, reporting $27,430 in compensation compared with $13,980 for directors without recruitment responsibilities. According to the report, most medical directors spent approximately five hours per week on directorship duties, regardless of practice ownership.

For more information about the report, click here.

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