According to a 2006 poll by the American College of Physician Executives, nearly 60 percent of doctors said they had considered getting out of medicine because of low morale, and nearly 70 percent knew someone who already had. In a culture that prizes risk and outsize reward some doctors feel they have slipped a notch in social status. It's not just because the profession has changed, but also because the standards of what makes a prestigious career have changed.
At least one in 12 patients who die has been diagnosed incorrectly, according to a 2003 analysis published in The Journal of the American Medical Association. Yet when trying to figure out difficult cases, doctors rarely use the highly accurate computer systems designed to help with the identification of ailments.
As the physician executive market matures, so do compensation methodologies.
In many cases, this means a greater focus on bonuses tied to performance incentives. More than half of physician executives reported receiving a bonus as part of their compensation package, according to the 2007 Physician Executive Compensation Survey, which was conducted by Cejka Search and the American College of Physician Executives (ACPE). This number is up slightly from the previous year's report.
More emphasis on bonuses typically translates into higher overall compensation for the executive. Median administrative compensation for executives with a bonus of 10 percent or less was $250,000, but administrative compensation levels increased as the bonus percentages rose:
The most common measurement of success is organizational goals--62 percent of respondents reported this bonus component. However, personal objectives, organizational profit, quality measurements, and patient satisfaction are also common measurements of executive performance.
The shift toward more incentive-based compensation is driven in part by the physicians themselves, says Lois Dister, vice president and practice leader with the Cejka Search executive search division. Physicians are more savvy when it comes to compensation packages than they were 10 years ago, and many are eager to tie a greater portion of overall compensation to their performance.
"[Physicians] realize how they can contribute to the clinical outcomes, the financial performance, and the overall goals of the organization. They get very excited by the opportunity . . . and they'll even suggest putting more money at risk," Dister says. "In the last couple of years, I've noticed a marked difference in how they view compensation and how excited they get about the bonus potential."
Physicians enter the C-suite Physician executives aren't just getting paid more; they're filling new roles and taking on true administrative responsibilities. Traditionally, physicians have held "medical director" and "chief medical officer" (CMO) titles, which account for 46 percent of the respondents to the Cejka Search/ACPE physician executive survey. But some are beginning to move beyond those positions, entering the C-suite and focusing solely on administration.
To attain these business administration physicians, some physician executives are obtaining postgraduate business management degrees, the most common being an MBA--one in five physician executives has this degree, according to the survey.
Palmetto Health Richland in Columbia, SC, will change the way ER patients are handled based upon recommendations from a team of MBA students at the University of South Carolina. The changes will include requiring medical staff to use checklists for procedures. The changes also will include hiring staff to be patient flow coordinators to track patients from start to finish through admission, diagnosis and treatment.
The Cedars-Sinai Medical Center in Los Angeles put pediatric patients in danger of harm, including actor Dennis Quaid's newborn twins, by giving them overdoses of the blood thinner heparin, California regulators have ruled. In a 20-page report, the regulators said the "violations caused, or were likely to cause, serious injury or death to the patients who received the wrong medication" and faulted the hospital for its "deficient practices" around administrating the drug.
Most physician-owned specialty hospitals are poorly equipped to handle medical emergencies, according to a report from inspectors at the Department of Health and Human Services. The findings underscore a long-standing concern about the rapid rise in the number of such hospitals. The report found that 55 percent of 109 physician-owned hospitals reviewed had emergency departments--and that the majority of those had only one bed. Fewer than a third of the hospitals had physicians on site at all times, and 34 percent relied on dialing 911 to get emergency medical assistance.