From IDSA survey data and other published surveys, we know ID physicians work more annual hours than their colleagues in many other specialties. We also know that, compared to a typical 1.0 FTE definition between 2,000 and 2,200 annual hours worked, most ID physicians are contributing the equivalent of more than a 1.0 FTE. See section V for additional details.

If a standard definition of a baseline FTE exists or can be developed and adopted within a division, department or medical group, changes in physicians’ contribution to the organization can be more clearly understood. Put another way, it is impossible to measure incremental effort without first establishing the expected, or baseline, effort. Understanding what is incremental is vital for ensuring it can be appropriately recognized. This section will provide an overview of how FTE definitions are generally determined in different practice settings.

A. CATEGORIES OF PHYSICIAN EFFORT Physician FTEs are commonly composed of the categories delineated below. However, the categories relevant to any individual physician are dependent on unique assignments (e.g., temporary or permanent administrative or directorship roles) and employment settings (e.g., private practice, hospital or health system employed, academic medical center employed). • Clinical time includes all patient-facing (billable) activities, such as inpatient rounding, outpatient clinic, restricted (in-house) call, unrestricted call and any associated administrative (nonbillable) clinical activity. Relevant administrative activities include encounter documentation in the EHR, returning/addressing patient calls or electronic messages, care plan coordination, interdisciplinary case conferences and teaching in the usual course of clinical care.

• Administrative time is for formally defined roles, such as a medical director, chair or vice chair; clinical leadership roles that have protected and/or compensated time; and other administrative roles. Examples of such roles include infection prevention, antimicrobial stewardship, quality and patient safety, medical or clinical director, telemedicine programs and others. A more comprehensive list of administrative roles is included in section III.F.

• Research time includes funded and unfunded research responsibilities, active grant management and the pursuit of grant opportunities.

• Teaching time includes actively teaching medical students, residents or fellows outside patient care-related clinical time.

• Strategic time involves other identified activities that support the organization’s, department’s or division’s strategic plans (e.g., new-practice startup, new-facility planning, EHR implementation, public health or media activities such as education, television or newspaper interviews).