Author: Ali Moin
Physician leadership roles continue to draw increased strategic focus from US healthcare organizations responding to changes in market data and national trends, as illustrated in Gallagher's latest annual Medical Director and Physician Executive Survey.
The 2024 survey reflects position consolidation, contract administration considerations and changes in payment-term structure, performance management and incentives. Further, the new data reflects national trends in new roles addressing physician shortages and natural disasters.
A total of 213 healthcare organizations reported compensation data for 109 medical director positions and 10 graduate medical education (GME) positions. Data represented 5,743 individuals holding medical directorships or GME roles, a 1.3% increase over 2023. Further, data includes 27 positions representing 839 individual physician executives — a 4.2% increase over 2023.
The survey gathers compensation data for a broad range of physician roles, from part-time medical directorships to full-time physician leadership positions. Survey data further reflects allocation of time as well as the methodologies organizations use to determine compensation for medical directors, GME roles and physician executives.
Results for hourly versus fixed rate compensation
Variable versus fixed-compensation methods
- 28.9% of organizations established their medical directors' compensation based solely on a variable/hourly basis.
- 33.1% of organizations applied a mix of variable and fixed compensation methods.
- 38.0% of organizations pay medical directors a fixed amount. Note that these stipends typically reflect an expected number of hours worked annually — a common market practice that our team has observed in recent years.
Median hourly rate increased in 2024 over 2023
- On average, median hourly rates increased by 3.71% from 2023 to 2024, with surgical positions showing the largest increase of 6.12%
- Hospital-based positions showed increased by 5.75%
- Medical positions increased by 2.54%
- Primary care positions showed hourly rate increase of 1.94%
Performance bonuses
- More than one-third of organizations offer a medical director performance bonus for at least some of their medical directors.
- Of the 64.7% not offering a performance bonus, 11.8% reported that they're considering implementing a performance bonus for medical directors.
- Organizations that offer an incentive put a significant percentage of income at risk (e.g., greater than 5% of base pay) for most of the physician leaders.
- Medical directors who earned an incentive bonus saw an average payout rate of approximately 65% of the maximum incentive opportunity.
Leadership trends reflect physician shortages and natural disasters
Our latest data shows that organizations are reporting new medical director positions to address emerging areas of emphasis. Examples include positions associated with neurohospitalists, physician wellbeing and rural health programs. Recognizing the continuing healthcare consolidation, we realigned our demographic metrics by adding more breakouts for larger health systems in multiple categories.
To address physician supply shortfalls, the Centers for Medicare and Medicaid Services added additional Medicare-funded residency positions. Community hospitals and healthcare systems have stepped up to provide this training, creating a robust physician recruitment pipeline.
Data further reflects new graduate medical education leadership roles, including designated institutional officers, residency/fellowship program directors and residency/fellowship associate program directors. Specialties include adult primary care, obstetrics and gynecology, psychiatry and surgery. We expect to see leadership positions for additional specialties in the years to come.
Lastly, as the US grapples with hurricanes, wildfires and other natural disasters, we've begun to see physician leadership roles tasked with disaster preparedness. While we didn't receive enough data to report in the current survey, we'll monitor this area going forward.
Participate in our next survey for a free digital copy of the report
Participation opens June 3 for the 2025 Medical Director and Physician Executive Survey. Participants receive a PDF copy of the survey report — a $4,500 value — when we publish results in November.
To participate in a survey, visit ajg.com/new-comp-survey.
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