With the health care industry transforming at a rapid pace, physicians are taking on larger, more complex administrative roles. Organizations ranging from hospitals to group practices are figuring out how to compensate doctors for those duties that are pulling them away from patients.

Compensation for directorship activities varies greatly depending on responsibilities and duties, and the type of organization, according to a survey of 1,399 medical directors by the Medical Group Management Association. About 50 percent of those surveyed say they spend fewer than six hours as directors. The vast majority of stipends were under $50,000, according to the report, and the median hourly compensation fell between $100 and $200.

At the hospital or system level, compensation for directors ranged from $15,600 for noninvasive cardiology and $16,000 for geriatrics to $58,040 for family medicine with obstetrics.

Quality metrics increasingly are being factored into stipends, especially as health care moves further away from the fee-for-service world, says Todd Evenson, assistant director of surveys for the MGMA.

Whatever the compensation approach, it's critical that physicians are involved at a leadership level in helping to change the way hospitals think and operate, says John Combes, M.D., president and COO of AHA's Center for Healthcare Governance.

"It's imperative that we engage physicians in redesigning the operation of the delivery system," he says. "The move is really more toward management of the clinical enterprise to focus it on outcomes for populations of patients, and to demonstrate value in doing that. And you can't do that unless you've engaged the people who are actually delivering the care."