A Comparison Study of the Roles and Responsibilities, Compensation, and Job Satisfaction of the Medical Directors of Kidney/Kidney-Pancreas, Liver, Lung, and Heart Transplant in the United States

This national cross-sectional survey evaluated the roles, responsibilities, compensation, and job satisfaction of medical directors in adult solid organ transplant programs in the United States. Responses were collected from 210 (34.5%) medical directors representing kidney/kidney-pancreas, liver, heart, and lung transplant centers. The findings reveal wide variation in compensation models and medical director duties across organ types. Kidney/kidney-pancreas directors reported lower compensation, despite leading higher-volume programs. Less than half of respondents reported that these duties were adequately recognized in their compensation. Only 40% of participants perceived their total compensation package as fair, and less than 50% understood how their compensation was determined. A third reported decreased job satisfaction compared to post-fellowship levels. Nearly half of respondents reported symptoms of burnout, with higher rates among women. Perceived fairness of compensation, adequate time with patients, and institutional support for non-clinical duties were associated with job satisfaction, while excessive calls and administrative burden were associated with burnout. These findings suggest more transparent and equitable compensation structures are needed. Incorporating the economic value assessment of transplant providers into institutional planning may strengthen justification for fair compensation models. These data provide a foundation for policy development aimed at enhancing workforce satisfaction and stability across transplant disciplines.