Is my medical-director stipend fair? How to check your number in three steps

You've been offered a medical directorship, or you've held one for years and never checked the number. The question is simple. The answer takes three steps, none of which involve the dollar amount you were quoted.

Here's the method, using what 2,614 hospitals reported paying their directors in Medicare cost reports.

Why the dollar amount can't answer this on its own

Take a $30,000 stipend. At 120 hours a year, that's $250 an hour, which lands near the 80th percentile of the national market. At 400 hours, the same $30,000 is $75 an hour, below the 5th percentile. Identical offer letter, and the answer flips from generous to poor depending on a number that's often nowhere in the letter.

This is why "the average medical director stipend is $43,000" isn't useful to you. It's true (that's the national median), but the median role logs 245 hours a year, and yours almost certainly doesn't. The dollar figure bundles your rate and your time together, and only one of those is comparable across arrangements.

Step 1: find your annual hours

What does the role actually require, per year? Three places to look:

• The contract — Many directorship agreements specify expected hours, a monthly minimum, or an annual cap. Start there.
• Your time log — If you're already in the role and logging administrative time (most agreements require it), you have the real number.
• An honest estimate — If neither exists: standing meetings, committee time, call-backs, protocol and policy work, survey prep, the calls that come at 7pm. Physicians routinely undercount this by half, so track a month before you settle on a figure.

If the role has no defined hours and no log, that's worth raising on its own. Hours are how these arrangements get documented and defended, and an agreement without them is a problem for the hospital as much as for you.

Step 2: divide

Annual stipend ÷ annual hours = your implied hourly rate.

That's the number the market is priced in. A $40,000 stipend for 200 hours is $200 an hour. A $60,000 stipend for 600 hours is $100. The bigger stipend is the worse deal, and no amount of staring at the annual figures would have told you that.

Step 3: compare to your specialty

Nationally, the median implied rate is $175 an hour. The middle half of the market runs $141 to $235, the 10th percentile is $102, and the 90th is $317.

But the national number is only your first landmark, because specialty moves the rate more than anything else. Some medians, all individual directorships:

• Specialty — Median rate · Filings
• Operating room — $217/hr · 556
• Radiology — $210/hr · 511
• Anesthesiology — $200/hr · 222
• Intensive care unit — $173/hr · 377
• Laboratory — $163/hr · 564

Yours is probably not one of these five. Look up your specialty's median in the free tool: it returns the median rate, median hours, and the number of filings behind both, for any of 62 service lines. That last part matters. A median built on 500 filings tells you more than one built on 30, and you should know which you're holding.

Then read your position honestly. Near the median with no unusual scope is an unremarkable arrangement. Well below it is a conversation worth having, especially if your hours have grown since the stipend was set (the most common way a fair arrangement quietly becomes a poor one). Well above it isn't a windfall to protect quietly; it's a number that should be supported by real scope and clean documentation, because your hospital's compliance team will eventually ask the same question you're asking now.

What "fair" does and doesn't mean here

This method tells you where your arrangement sits against the market. That's genuinely useful, and it's what you need walking into a negotiation: a number, a source, and a sense of the range.

What it isn't is a determination that your specific arrangement is fair market value. That's a formal analysis of your actual duties, qualifications, the hospital's circumstances, and the whole relationship between you and the facility, and it belongs to a qualified appraiser. Your hospital may already have one on file for your role. It's reasonable to ask what it says.

Bring the rate, not the stipend. "My implied rate is $128 an hour against a specialty median of $173" is a discussion, while "I want more money" is a mood.

Two practical notes on using this in a conversation. Bring the rate, not the stipend. And if your hours have drifted well past what the agreement contemplated, that's often the stronger argument, because it's a documented change in the work rather than a request to reprice it.

Where to go from here: how many hours these roles actually run, what hospitals pay across all specialties, and, if you want the version your hospital's appraiser would use, the full benchmarking method.

Sources and method

• Source — CMS Form 2552-10 Worksheet A-8-2, Medicare hospital cost reports
• Period — FY2024–2025, one filing per hospital
• Analysis set — 9,608 individual directorships across 2,614 hospitals and 62 service lines
• Rate definition — Recognized compensation divided by reported hours; top and bottom 1% of implied rates trimmed
• Your figures — The calculator runs in your browser. Nothing you type is sent anywhere or stored
• Known limits — Self-reported and unaudited; filings lag 12 to 24 months; recognized comp is not identical to contract terms

Full methodology and limitations

Disclaimer

This article is a market-data benchmarking resource derived from publicly available Medicare hospital cost reports. It does not provide, and must not be relied upon as, a fair market value determination, valuation opinion, appraisal, or legal, tax, or compliance advice. The opinion of value for any specific arrangement remains the professional judgment of a qualified appraiser.