Salary disparities are increasing between procedural and cognitive subspecialties and between research- or education-oriented faculty and predominantly clinical faculty, while traditional salary differences between junior and senior faculty are shrinking. At the same time, funding for faculty salaries is challenged by declining reimbursement for clinical activity, the NIH cap on research salary support which prevents adequate reimbursement for research effort, the need to compete with salaries offered by the private sector, and the lack of support for educational activity. In this environment, how can chairs effectively cross-subsidize the salaries of research- or education–focused faculty? Are salary disparities disruptive to morale, or simply the new normal? How can chairs argue effectively for institutional subsidies and support when other departments face the same challenges? Are there novel revenue sources (philanthropy, concierge medicine, legal consulting, device and Pharma industry relationships) that can fill the gaps?
1. Understand the various funding resources available to a faculty member within a university setting and identify the internal/external pressures associated with each resource.
2. Examine alternative funding for clinical compensation that may not be directly related RVU (Relative Value Unit) production, but is necessary for the university Neurologist to remain competitive with private practices (directorships, committees, call pay, etc.).
3. Develop systems to understand what each Neurology patient is worth to the institution in terms of direct patient care and downstream revenue. Understand the total financial picture of a patient presenting to the institution with a Neurological condition and track the total financial contribution.
4. Related to morale/burn-out, offer non-monetary means for compensation to the university Neurologist – protected research/educational days, funding for educational activities/conferences, provide an environment conducive to fostering research activities (bench and clinical trials), etc.