Watch all four parts of the training on the player above, or click the buttons below to watch individual episodes on YouTube.
Synopsis
Base salary is usually a function of FTE, and productivity thresholds are usually prorated by it. So when an FTE record is wrong or out of date, the error reaches incentive pay, pay equity, and the fit between your compensation plans and your clinical operations.
In this four-part series, Eric Leafgreen, VP of Physician Compensation and Strategic Services at Ludi, walks through the three pillars of FTE management. Standards and definitions set what a 1.0 FTE means in your organization. Record keeping and processing give you one accurate source of truth for FTE status and a documented way to approve changes. Calculations and payments set clear rules for how FTE affects productivity pay, base salary, and base obligations.
Each part runs under six minutes. Start with Part 1 for the overview, or go straight to the pillar your team is working on.
In this Series
Part 1: The Foundations (2:31)
Why FTE management matters for incentive compensation and equitable pay, and a first look at the three pillars.
Part 2: Standards & Definitions: Defining a 1.0 and Mapping the Structure (5:52)
- Three ways to set the standard: a fixed work schedule, actual work hours, or actual shifts
- Annual work standards of 2,000 or 2,080 hours, and why they need to be adjusted for approved absences such as PTO, sick time, holidays, and CME
- Clinical schedule models, from a traditional five-day week to block sessions and compressed schedules, with call coverage layered on top
- Protected time for physicians with administrative duties, and the FTE categories most organizations use: clinical, administrative, research, and teaching
Part 3: Record Keeping & Processing: An Accurate Source of Truth for FTE Status (5:09)
- Why HR systems built to track total FTE for benefits eligibility fall short for physicians and clinicians
- What an FTE record for physicians and clinicians needs to capture, and what it needs to connect to
- What every FTE change approval should document
- Handling changes that can’t be made prospectively, plus guardrails on the timing of changes and FTE increments
Part 4: Calculations & Payments: Clear Rules on How an FTE Affects Compensation (4:06)
- Spot FTE versus effective FTE, with a worked example
- The questions that decide how FTE status affects productivity pay
- Why base salary relies on spot FTE, and the case for stating compensation plans on a 1.0 FTE basis
- Base obligations for hospital-based physicians and physicians who provide call coverage
Questions this series answers
How many hours is a 1.0 FTE for a physician?
Most organizations use an annual standard of 2,000 or 2,080 hours, then adjust it for approved absences such as PTO, sick time, holidays, and CME. In Eric’s example, 2,080 hours less about 256 hours of approved absences leaves about 1,824 annual work hours, or about 88 percent of the standard. Applying the same adjustment to fixed-schedule and shift-based physicians keeps their FTE comparable.
What is the difference between spot FTE and effective FTE?
Spot FTE is FTE status at one point in time. Effective FTE is FTE status over a period, such as a calendar year, a fiscal year, or an incentive performance period. A clinician at 1.0 clinical FTE for six months and 0.5 for the next six has an effective FTE of 0.75 for the year. Productivity pay usually relies on effective FTE. Base salary relies on spot FTE.
What should an FTE change approval document?
The current FTE status, the proposed FTE status, the date of the change, whether the change is permanent or temporary, the business reason, whether the contract needs to be amended, and the approval itself. Changes are best made prospectively. A change that falls in the current financial period or one already closed needs an escalated review, because pay may need to be recalculated or financial records restated.
Why isn’t an HR system enough to track physician FTE?
HR systems are designed to capture total FTE, mainly to determine benefits eligibility. Physician and clinician compensation needs FTE by category (clinical, administrative, research, teaching, and academic), a connection to financial reporting and analytics, and a direct link to pay calculations such as productivity thresholds and base obligations for call coverage.
Related
FTE Management on The Ludi Platform
FTE Measurements: Strategies for Accuracy & Risk Mitigation, by Eric Leafgreen