Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Sunday, May 18, 2014

Discovering America

The big news in the NY Times:

Doctors’ Salaries Are Not the Big Cost

"...a startling secret behind America’s health care hierarchy: Physicians, the most highly trained members in the industry’s work force, are on average right in the middle of the compensation pack.

That is because the biggest bucks are currently earned not through the delivery of care, but from overseeing the business of medicine."


Another big news item:


Maybe the idea that doctors like to make a living, and some doctors even take advantage of the system, is just juicier news than that business executives like to make a living and often take advantage of the system.

My favorite part of the article?

"Hospitals and insurers maintain that large pay packages are necessary to attract top executives who have the expertise needed to cope with the complex structure of American health care, where hospitals and insurers undertake hundreds of negotiations to set prices."

Translation: "We created lots of unnecessary work to justify our existence, and now we pay ourselves a lot to do that work."

A quick rundown:

$584,000 on average for an insurance chief executive officer, 
$386,000 for a hospital C.E.O. and 
$237,000 for a hospital administrator, compared with 
$306,000 for a surgeon and 
$185,000 for a general doctor.

More importantly, the executive salaries don't reflect full compensation:

"Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million...
Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million."

In all honesty, I wouldn't mind how much money these executives make if they actually did something to improve the state of healthcare. But as far as I'm concerned, they're being paid for destroying it. Maybe we should all go out and mess up some other industry so we can demand huge compensation packages.