Just Compensation for Consulting Transplant Physicians in Donor Management

1
Just Compensation for Consulting Transplant
Physicians in Donor Management

• George B. Mallory Jr. MD
• Director, Lung Transplant Program
• Texas Childrens Hospital
• Houston, Texas

NLC A9- Wed. Oct 18, 945-1030 F8- Thurs. Oct
19, 1100-1145
2
Principle and Challenge

• Just compensation for professional work
• Challenge many/most physicians will be salaried
  academicians
• Billing for services rendered is feasible but
  often foregone consultation for patient
  management invasive procedures.
• Payment by normal default goes to Department with
  no credit to the individual

3
Professional context

• The collaborative is infused with enthusiasm and
  testimonials of success, but talk is cheap.
• Actual and potential physician champions are
  usually professionally over-extended at baseline
• Potential physician champions often
  under-appreciated in the workplace for
  txp-related work and extracurricular activities
• Incentive for more work with sleep disruption may
  be marginal to non-existent

4
Personal Testimony

• Frequent nocturnal consultation for general
  management of ventilator in early phase after
  diagnosis of brain death
• Consultation for flexible bronchoscopy as part of
  organ-specific evaluation
• Consultation if lungs offered to us for ongoing
  vent, lung, antibiotic, fluid management
• Approximate time per month 10-15 hrs
• Current charge 0

5
Proposal

• Whereas there is reasonable evidence that
  individuals work harder and better if rewarded
  for their work, some system of compensation
  similar to arrangements related to legal
  consultation should be developed in cooperation
  among transplant physicians, their
  employer/Departments and the OPOs should be
  developed.
• National dissemination of workable models