Quote:

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Intermountain Healthcare the largest medical provider in the state will cut pay for physicians, nurse practitioners and physician assistants during the coronavirus outbreak, which an administrator said in a message sent to staff last week is financially necessary amid "the changing needs."

The salary reduction discussion comes despite the growing demand for medical professionals to respond to the pandemic. Some hospitals across the country are being overwhelmed with coronavirus patients.

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https://www.sltrib.com/news/2020/03/30/intermountain-is-cutting/


I personally cannot think of a worse way to treat health care providers right now, especially with grueling workdays. Federal money is in the pipeline and this will end someday. And ideas from docs or nurse practitioners?

Edit: the story goes on to say that advanced practitioners would be paid if reassigned other duties, but surely there is sufficient non-Covid work to keep them busy?

This is a product of elective cases being cancelled. No money coming in means no money available to go out. I am sorry it doesn't seem fair. Lots of us are dealing with this reality in health service delivery.

Our entire healthcare system needs retooling

The hospitals are in a world of hurt. They make their money off the elective surgical procedures; not from treating people for weeks in ICU.

As an outpatient pediatrician I'm paid mostly by the patients I see day to day. Productivity.

I was seeing 24-30 most days now I'm seeing 6-10 so my pay has effectively been reduced 60%

I am not that worried as the backlog on demand is going to be huge this summer and I will crank back up. Trying to enjoy the slower days as much as possible. Plus "saved" income due to cancelled trips.

well put and good attitude KidDoc

The issue that many have with this is that the same hospital system expects administrative salaries to remain intact. When you consider provider salaries make up about 8% of health expenditures they're not even cutting from the main expenses. But they'll collect a full paycheck while working from home while the docs and nurses on the front line take all the risk from a health and financial stand point.

MediAg13 said:

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The issue that many have with this is that the same hospital system expects administrative salaries to remain intact. When you consider provider salaries make up about 8% of health expenditures they're not even cutting from the main expenses. But they'll collect a full paycheck while working from home while the docs and nurses on the front line take all the risk from a health and financial stand point.

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That is an excellent point.

Not sure exactly how this would have an effect on providers getting paid by insurance companies. Patients are still subscribers for insurance and those premiums have not been reduced.

However, payouts from insurance companies to providers has been reduced in terms of fewer elective cases, and scroll down to see how it is affecting primary care and pediatrics.

I'm also down 50-60% in preventative and acute office visits and insurance is now able to hold the money they would have paid for high volume elective cases like colonoscopies and minor elective cases like cataract repair.

If anyone is getting ahead now, it's the insurance companies. They may have their own correction once the critical care claims roll in but cutting payments to providers does not exactly inspire me right now.

MediAg13 said:

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The issue that many have with this is that the same hospital system expects administrative salaries to remain intact. When you consider provider salaries make up about 8% of health expenditures they're not even cutting from the main expenses. But they'll collect a full paycheck while working from home while the docs and nurses on the front line take all the risk from a health and financial stand point.

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That was my concern as well. Administrator salaries won't decline.

Well....new york is paying nurses 100 per hour, plus hazard, plus per diem, plus room and board, plus private transit- including pay for transit....tell them to go to NY.

I never understand why employees dont think they have the power to go work elsewhere. When the employer realizes their mistakes, they've lost all leverage. Who wants to work for crappy culture anyway?

My experience with healthcare administrators has been so entirely negative that I can barely put it into words. Some seemingly nice people will turn pure evil on you in a heartbeat if it can save them a dollar. Many are trained in business but have absolutely no clue what goes on at the bedside.

There was a big Medscape article yesterday where apparently hospital administrators on the west coast have been rounding on units, telling nurses to take off masks because it was scaring the patients and bad for customer service.

jftx04 said:

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Well....new york is paying nurses 100 per hour, plus hazard, plus per diem, plus room and board, plus private transit- including pay for transit....tell them to go to NY.

I never understand why employees dont think they have the power to go work elsewhere. When the employer realizes their mistakes, they've lost all leverage. Who wants to work for crappy culture anyway?

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Exactly. Our hospital culture was incredibly negative for nurses and doctors even before this virus. A lot of folks have left over the last year or two. They were forced to pay people like me a ton of overtime and were offering five-figure signing bonuses for experienced nurses.

Maybe one day a light bulb will go off and they'll realize that brain drain and turnover are both expensive and they might be better served just treating their staff better to keep people from leaving.

And it really isn't even about money, it's about communication and listening to people. I worked for a hospital going through a major construction project. There were zero patient care people on the committee to help approve the design. Administrators allowed the architects to put supply closets and nurses stations literally hundreds of feet away from patient care rooms. They wanted it to look fancy but made it entirely non-functional and potentially dangerous.

My current hospital recently installed a new communication and call light system. Again, no people who would actually use this system were involved in selecting it. Not only does it not work well, the design of the controllers make it easy for patients to repeatedly call the nurse by accident. We were told these accidental calls help increase patient interaction and customer service opportunities. These same people gripe at us constantly for not being efficient with our time.

Any of you posting with confidence that IM administration will be unaffected while their providers take the cuts... have any actual evidence? I am friends with a few of theIt execs and I'll ask them.

At my hospital the top execs took 45-60% cuts to compensation before asking our providers, nurses or staff to take a 10% reduction. We're still bleeding about $750k per day.

I know about 50-100 c-suite execs in healthcare and frankly they include some of the greatest people and nicest Aggies you could meet. Not sure why any here believe otherwise.

I'm a CPA and not a doctor. But based on my experience as a consultant in the health care field, I've found that hospitals are typically horrible managed. There is normally bloat at every level of the system.

FrioAg 00 said:

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Any of you posting with confidence that IM administration will be unaffected while their providers take the cuts... have any actual evidence? I am friends with a few of theIt execs and I'll ask them.

At my hospital the top execs took 45-60% cuts to compensation before asking our providers, nurses or staff to take a 10% reduction. We're still bleeding about $750k per day.

I know about 50-100 c-suite execs in healthcare and frankly they include some of the greatest people and nicest Aggies you could meet. Not sure why any here believe otherwise.

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I'm sure that's been the case. I don't see how they could justify cutting physician pay without cutting their own, it would be a really bad move and sow a lot of distrust.

I did work a very short contract with a hospital system that had a fantastic culture and IMO the patients could sense it as well.

I don't really care if managers are nice people or not. What we need in healthcare are leaders who actually understand healthcare.

All the executive team at my hospital including myself volunteered for a 40% pay cut while still working 12 hour days. I don't know why you think admin is unaffected by this. We are all hurting. We don't do this because we want to, we are all making tough decisions every day so that there is a hospital to come back to when this is all over.

Also there is a very real fair market value issue with compensating physicians and mid levels for more than they are earning in productivity. Keeping their salaries the same while they see 10% of their former volume is illegal.

In the past 40 years physicians have increased 150%, in that same span, administrators have increased 3200%.

The revenue for hospitals comes from OR, cath lab, GI procedures. When those are shot to about 10-20% of normal flow, entire hospital is in trouble.

I've heard of some system's furloughing employees for to return when things get busy. I wonder if this rapid results COVID Test will allow SOME early return of normal operation.