PC1133: A Comparison of a NICU Medical Director to a Clinical Neonatologist

Background: Other authors have reported on how the medical director role requires a diverse skill set and report on their leadership experiences. Data that summarize the diverse professional activities of a NICU medical director are lacking. Such data are needed to align resources with expectations to empower neonatologists in this critical leadership role to build clinical teams and to improve newborn care. We aimed to compare the professional profiles of neonatologists who served as NICU medical directors and neonatologists who self-identified as primary clinicians without administrative responsibilities.

Methods: The AAP conducted a voluntary anonymous survey of all board-certified and eligible United States neonatologists from July to November 2021. 2113, or 30%, of surveyed neonatologists responded. The survey included questions about professional duties, social factors, and compensation. We used the subset of respondents who were board eligible or certified, held a full-time position, and self-identified as either a medical director or a clinical neonatologist (defined in the survey as a neonatologist focused on providing clinical care to patients, with or without supervision of students, residents or others). Statistical analyses, including t-test of means, Wilcoxon test of medians, and chi-square analysis, as appropriate, were performed using JMP 16.1.0 by SAS (Cary, NC).

Results: Of the 1262 active full-time physician respondents, 792 classified themselves as either a medical director or a neonatologist clinician.. Among general characteristics, medical directors tended to be older and more likely to be a member of the AAP Section on Neonatal Perinatal Medicine. There were no meaningful differences in clinical responsibilities. Medical directors were more engaged in research (48% vs 27%, p< 0,001), had more publications, were more likely to hold an academic appointment, and achieved a higher academic rank (p < 0.001). Medical directors also had over twice as much administrative time (12 vs 5 weeks, p< 0.001) and held more leadership titles. The median total cash compensation of a medical director was $45,000 greater than for a clinical neonatologist (p < 0.001) with $20,000 derived from an administrative stipend (p < 0.001).

Conclusion: Medical directors had higher administrative and scholarly expectations as compared to clinical neonatologists. Better understanding of the professional productivity of medical directors will better inform institutional strategic planning and development of clear professional expectations.