Education incentives are a smart choice

By G. Michael Barton, SHRM

Vice President, Human Resources

Regional Medical Center

Madison, KY

(Editor’s note: This is the first in a two-part series about education incentives. This month, we look at some of the key areas to consider in preparing an educational incentive package to make your institution more attractive to a physician candidate. Next month, we’ll explore other educational incentives, including monetary rewards.)

Changing technology and the continuing need to refine skills in delivering medical services make it imperative to offer physicians a broad scope of opportunities to attract them to your organization and to enhance their personal development over the long term.

Many medical organizations overlook the importance of providing education incentives to physicians. Some organizations offer physicians the opportunity to attend a seminar or "in-depth" program on an annual basis thinking this will satisfy the need for personal development. This outdated approach will not only stifle physician recruitment efforts but also severely damage retention and ultimately the quality of medical services.

An education plan should be developed with each physician. (A sample education plan is inserted in this issue.) This plan should be developed by the physician with input from the department chair, medical director, partner, fellow physicians, or medical education coordinator as appropriate. Here are some areas often included in physician education plans:

Continuing medical education: This area includes the required continuing education needed to maintain a medical license. There are 54 U.S. licensing jurisdictions for physicians, many of which have specific requirements for continuing medical education in order to maintain licensure.

Specialty training: This applies to the areas that are outside the normal scope of the physician’s practice such as surgery, psychiatry, pediatrics, geriatrics, or epidemiology.

Technology: Assistance in keeping up with new medical technology such as telemedicine, laser surgical techniques, and computerized medical records is essential in today’s fast-changing technological landscape.

Practice management: This comprises any areas that strengthen the physician’s ability to maintain a successful medical practice. Training in communications, financial management, customer relations, marketing, continuous quality improvement, statistical monitoring, and planning are a few examples.

Research: The ability to pursue areas of in-depth study that are of special interest such as AIDS, cancer, cardiology, or memory loss are attractive to physicians.

Personal Skills: Offering further education in non-medical areas that impact the personal development or address individual needs such as computer skills, stress management, negotiation, time management, communications, public speaking, personal financial planning, and personal fitness can help seal a recruitment negotiation.

Knowing what to offer

The level of commitment of monetary resources by your organization is the first factor to consider in determining what to offer the physician. The monetary commitment not only involves payment for education programs but also the value of the time spent away from a medical practice while pursuing the education and the cost of integrating the education into your organization or medical practice.

It is important to ask — and answer — the following questions as a guide for what to offer:

Money: What can the organization afford to provide?

How will the cost of education impact the cost of the service provided to the customer?

What grant monies, if any, are available to defray some of the cost?

How should the incentives be structured; as a fixed reimbursement amount, as part of the physician’s overall compensation package, or based on performance?

Time: Can the organization afford for the physician to be away from his or her practice?

What arrangements, such as a fill-in, are available to cover for the physician?

What time limitations should be imposed without limiting the physician’s development?

What innovative approaches can be used that would limit the time the physician is away from his or her practice?

Integration: How can the education be integrated into the physician’s practice? For example, does the family practice physician who receives training in treating patients with memory loss have a significant geriatric population with a documented need for this training?

How can this training expand the patient population the physician is now seeing? A surgeon who is trained on how to perform laparoscopic hernia repairs, for example, could expand referrals for patients needing this procedure.

Quality and service are the last two factors to consider when designing education incentives. Quality can be measured by how the education positively impacts the clinical outcomes of the patient. For example, if training in laser surgical techniques can be transferred to the physician’s practice, reduced lengths of stay in the hospital and fewer repeat surgeries may be documented outcomes.

Service also can be tracked since the physician can treat a different patient population by learning laser surgical techniques. Service is further impacted because the patient experiences a shorter recovery time.

After cost, quality, and service have been thoroughly considered, the physician and the hiring organization are ready to identify what education programs and incentives should be provided.

A written document, such as an "employment agreement" should be used to delineate what education incentives will be provided to the physician. An employment agreement spells out conditions of employment, compensation, and any benefits provided as part of the contractual arrangement. Here is an example of such a contractual arrangement that establishes medical competence:

Only those physicians holding an appropriate medical license and offering acceptable evidence that their training, current competence, professional ethics, and commitment to providing quality care, as determined by the Medical Staff or Board of Directors will be eligible for employment and Medical Staff membership. Each member of the Medical Staff is required to maintain ongoing proof of competence and must complete at least 50 hours of continuing medical education annually.

As part of the physician’s proposed schedule of benefits, reimbursement for education and development can be established in the physician’s contract or employment agreement.