The following are key points to remember from the 2019 American College of Cardiology (ACC) Health Policy Statement on Cardiologist Compensation and Opportunity Equity:

1. Compensation and opportunity equity are critical complements of a fair and professional work environment and a successful business model for cardiologists, and should reflect the ACC’s core values: Patient Centered, Teamwork and Collaboration, and Professional Excellence; and its mission of “Transforming Cardiovascular Care and Improving Heart Health.”
2. This health policy statement elucidates a set of principles for the development of compensation plans that advance equity in both compensation and access to opportunity.
3. Designing and implementing an equitable compensation model requires leadership and strategic thinking. A plan designed in a vacuum, or one that does not support the vision and mission of the organization, will not be sustainable.
4. Across the house of cardiology, leadership has a responsibility to ensure equity. While differences in institutional, practice, or academic unit missions, goals, and situations mandate that each compensation model be individualized, key principles exist. These include equity, clarity, transparency, prospective development, accountability, flexibility, and sustainability.
5. No compensation plan can provide fairness unless there is also equal opportunity to maximize performance and advancement. The ACC believes that adherence to these principles will improve the performance and satisfaction of our cardiovascular workforce, enhance team-based care, and ultimately benefit patient and population health.
6. The ACC believes that cardiologist compensation should be equitable and fair for equivalent work and objectively determined by a modeled systems approach that is prospectively developed and based on consensus principles.
7. The ACC believes that cardiologist compensation should be fully aligned with an organization/practice’s business strategies, mission, and core values; individualized to reflect performance, productivity, and other prospectively determined factors; and designed to minimize unwarranted systemic differences based solely on subspecialty.
8. The ACC also believes that cardiologist compensation plans should value and explicitly reward nonbillable work, including quality improvement, leadership/administration, teaching/mentoring, research, community service, and outreach activities, include strategies and formulae that offer flexibility to accommodate different job descriptions, and explicitly address and incorporate leave policies.
9. The ACC believes that cardiologist compensation plans should define those activities and behaviors that will result in an increase or decrease in compensation, should not utilize salary history in setting cardiologist compensation, and starting compensation at a given institution or practice should be the same for all individuals at a given rank or position within a given subspecialty of cardiology at that institution or practice.
10. The ACC believes that cardiologist compensation plans should be transparent in terms of the approach, methodology, and calculations used to determine individual compensation, should include the tools and education required to achieve a fundamental understanding of compensation terms and processes in aggregate as well as how these apply in determining individual compensation, and recognize that equity in cardiologist compensation ultimately depends on equal access to career opportunities.
11. The ACC believes that, as part of ensuring opportunity equity, cardiology leadership should be responsible for mitigating the effects of unconscious or implicit bias and creating a culture of inclusion and cardiology practice/division leadership to be responsible for equity in compensation and opportunity, and should be accountable for creating and implementing fair policies and adhering to compensation best practices.
12. Finally, the ACC believes that both cardiology leadership and impartial external experts should regularly and frequently review cardiologist compensation models, metrics, and actual total compensation, including bonuses, and access to resources and opportunities, and do so with reference to national benchmarks.

Keywords: Benchmarking, Bias, Cardiology, Compensation and Redress, Consensus, Health Policy, Institutional Practice, Job Description, Leadership, Mentors, Personal Satisfaction, Primary Prevention, Quality Improvement, Reward, Salaries and Fringe Benefits, Social Responsibility, Social Welfare, Workplace

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