October 1, 2007


Thinking Outside the Box
Alternative Sources of Income

Infectious disease physicians can boost their income without working longer hours or increasing the number of patients they see. That was the message from Patrick Joseph, MD, FIDSA, at a session during IDSA 2007 titled “Thinking Outside the Box: Alternative Sources of Income.”

While infectious diseases physicians have seen a substantial boost in their Medicare payments this year, the outlook for future years is much less certain. As it becomes more difficult to make ends meet by seeing patients, Dr. Joseph emphasized that activities besides patient care can boost income for infectious diseases physicians..  Most other sources of income are reimbursed at a greater rate than patient care, but negotiation is a key skill.  

In a survey of 88 California infectious diseases physicians conducted by Dr. Joseph, lecturing, infection control, and antibiotic utilization programs were listed as the top means of supplemental employment.  Lab work or directorships, pharmacy administration, and private industry consultation ranked the lowest.  He emphasized continuously searching for opportunities as a means to ensure continued success, adding that for each problem in a hospital there is an opportunity for employment. 

Revisions to the rules governing physicians’ referrals to institutions where they are already working, commonly referred to as Stark II, allow more freedom for ID physicians to negotiate compensation for infection control activities. Compensation arrangements can still be scrutinized by the Office of the Inspector General (OIG), Dr. Joseph cautioned, but there are ways to prove your worth, including keeping track of invoices and W-2s. 

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Thinking Outside the Box
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