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May 2016
What is IDSA Doing about the Future of ID?
The results of IDSA’s Compensation Survey conducted among members last fall have been published in Open Forum Infectious Diseases (OFID). The objective of the survey, undertaken by IDSA’s Clinical Affairs Committee, was to offer a more accurate representation of compensation across the specialty by using a larger sample size than previously published surveys. Several findings stood out to me and have sparked impassioned discussion among our colleagues.
While detailed findings for those who identified their area of focus as “Research,” “Public Health,” and “Other” are available in the full survey report, the authors focused their analysis on those who indicated “Patient Care” as their primary responsibility as this group represents approximately 50 percent of IDSA’s membership. The finding that seems to have provoked the greatest response is that private practice physicians’ income averaged $277,611 (ranging from $50,000 to $1.45 m), with a median range of $170,000 to $272,500 across the sub-segment of patient care. ID specialists employed at academic medical centers reported the lowest compensation level of all of the patient care sub-segments. Clearly, there are outliers in this data but, understandably, the authors included them in order to demonstrate the broad range reported by members. 
The response to the compensation survey was reminiscent of the response to last year’s Match results. A thread within both responses was, “What is IDSA doing about it?” 
As noted in an IDSA-sponsored study and accompanying editorial recently published in Clinical Infectious Diseases (CID), those who choose the field of ID do so for the love of the specialty, the intellectual challenges, the unique opportunity to look at the whole patient rather than one specific organ or system, and the chance to improve and protect the health of the entire population. So, it’s not surprising to me that there is frustration with the pace of change within the field, in terms of how the specialty is compensated, and in terms of making sure that the best of the best are drawn into our field. I assure you that while change may be slow and incremental, IDSA is engaged on several fronts and numerous initiatives and is committed to realizing real and tangible change. 
Dan McQuillen, MD, FIDSA, a past chair of the Clinical Affairs Committee (CAC) and current IDSA co-chair of IDWeek, outlined in a recent blog post several such initiatives, including our participation in the Cognitive Care Alliance (read more about the Alliance here and here), which has as its goal to harness the collective power of cognitive specialties to raise awareness among policymakers that the current payment system undervalues the complex medical decision-making that is foundational to cognitive care. In addition, members of the CAC have been working on developing billing codes that capture the non-face-to-face work related to patient care that ID specialists perform.  As well, members of the CAC have been focused on promoting performance-based contracts for administrative services such as infection control and antimicrobial stewardship that align with hospital value-based performance metrics. The Compensation Survey is but one piece in an extensive, concerted effort aimed at bolstering the value of the ID specialist. 
Our advocacy work on Capitol Hill also offers opportunities to promote the value of infectious disease specialists, particularly during outbreaks such as Ebola and Zika. The policy team and member spokespersons continually work to educate Members of Congress and their staff about physician workforce issues as well as unique ID issues and have urged them to direct the Centers for Medicare and Medicaid Services to undertake the research necessary to update the evaluation and reimbursement codes for ID specialists.  
In addition to these efforts, the ID Recruitment Task Force, led by Wendy Armstrong, MD, FIDSA, is making good progress on a number of fronts, including efforts to re-evaluate microbiology curricula at medical schools, as detailed in another recent study in CID. We’re also making progress on IDSA’s messaging campaign in which we are targeting audiences and developing messaging that communicates the value of the ID specialist to policy makers, payers, hospital execs and others along with an additional set of messages to reach those starting out in medicine about the rich and rewarding career that infectious diseases offers. 
I want to thank each of the individual IDSA members who are leading efforts to address these concerns for the benefit of the entire specialty. They continue to carve out from their own personal time to advance these vexing, complex issues that make up the goals of our Society. 
Another important message that came across loud and clear to IDSA leadership is that we need to be better at communicating to and informing our members about the priorities and initiatives underway to address concerns that we deeply share with you. Two exciting announcements on that front are:
  • At IDWeek in New Orleans, we will be hosting a town hall style “Securing the Future of ID” meeting. You will hear from me, Carlos del Rio, MD, FIDSA, chair of the Board of the HIV Medicine Association, and others about ongoing efforts by IDSA and HIVMA to advance the field that all of us hold dear. But this won’t be a one-way discussion. We want to hear from all of you. The town hall will be an interactive opportunity for you to speak up, share your thoughts and concerns, and spark novel ideas.
  • In addition, we will soon be launching a newly crafted “MyIDSA,” the members-only section of the IDSA website. This will become your destination for networking with your colleagues and strengthening the community of IDSA. You’ll be able to join lively online discussions, pose questions, find colleagues, and find the latest news from the Society. We’re aiming to harness the energy and excitement of the hallway conversations at IDWeek, put them online, and make them last throughout the year.
I look forward to engaging with every one of you through these two exciting platforms. I’ve always been proud to be an infectious disease specialist and a member of IDSA. I’m excited about continuing to work with all of you to make our specialty and our Society stronger.

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