The ACP Advocate Blog
by Bob Doherty
Wednesday, February 25, 2009
Are the salaries that medical schools pay to physician-executives anyone's business?
Three of the top four (and eight of the top 10) highest-paid employees of U.S. colleges and universities were physicians, reports Jacob Goldstein in his Wall Street Journal health blog. (The top spot went to a college football coach, U.S.C's Pete Carroll, at $4.4 million.) The next three highest earners were physicians:
David N. Silvers, a Columbia dermatologist, $4,332,759.
Michael M.E. Johns, Emory's executive vice president for health affairs, $3,753,067.
Arthur H. Rubenstein, University of Pennsylvania executive vice president and dean, school of medicine, $3,335,767.
Goldstein comments that, "The leading place of docs on the list is a reminder of just how much money flows through medical schools and academic medical centers, both in the form of reimbursements for patient care and federal research dollars."
The comments posted in response are well worth a read.
Some expressed concern that a misperception may be created that all physicians are paid so handsomely when those in the trenches - especially primary care doctors - make only a small fraction of the money paid to these executives. One physician commenter asked "What message on the campus does it send to medical students? Does this represent nationality priorities when 40+ million people have no health insurance?"
Another physician writes "Academic medicine has lost its mind. They preach dumb healthcare policy while collecting overinflated salaries. What hypocrisy. I would bet the barn that not one of these guys could survive the rigors of the real world practice of medicine in the trenches of primary care. Yet they pontificate from their ivory towers. Eventually these towers will fall."
Others noted that the reported compensation levels are not out of line when compared to other CEOs of successful companies and other learned professions.
My favorite: "If only the docs learned to coach football ..."
Is it really anyone's business what these physician-executives are paid?
Believers in market-based capitalism would say no, physician executives, like anyone else, have the right to earn what the market will bear. And academic medical centers, like any business, have the right to pay top dollar to attract top talent.
The counter to this is that medical colleges and academic medical centers are not like any other business. They serve a public mission of teaching the art and science of medicine to the next generation of physicians. And they receive billions of dollars from federal and state governments.
My guess is that at a time when the salaries of executives in other businesses receiving federal funding are under scrutiny, physician compensation in academic medicine will be viewed as fair game.
Academic medicine will have to address a public perception that taxpayers can't afford to subsidize high physician executive salaries, when millions of Americans have no health insurance coverage, when medical students graduate with an average of $140,000 in debt, and when primary care physicians in patient care earn 5% of the amount paid to the lowest of the top four physician-executives employed by medical colleges.
They might be well-advised to have a chat with their school's football coach on how to run a good defense.
Today's questions: Do you think it is anybody's business what physicians in academic medical centers are paid?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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