Compare your pay to a CEO's!! A must read!

natalie · May 10, 2001

essarge-I wish there was easy access to the nonprofit, private CEO's wage. This is the bulk of the hospital management. Oftentimes, they hide under this cloak, collecting obscene amounts because the public generally believes "well, the hospital is nonprofit and surely everyone is honest and fair with wages."

It's neat to check some of the for profit hospital corporations. Tenet healthcare CEO made over 3 million last year and one year he collected over 20 million in salary and stock options. That's sickening. It could have bought over 450 nurses at 40,000/year.

Dplear · May 10, 2001

What is so wrong with making money in this day and age? Sure the CEO of Tenent made over 3 mil last year. he also has a responsibilty commensurate with the pay. Do you want his job, probably not. He probably has less job security on his job than you have in yours. I read every day where CEO's are being replaced. Maybe if you read the business section once in a while, you might see that happening. I know that i am going to take a whole load of heat for this post, but that is all right with me. Remeber healthcare IS a business and you can not continue to operate without making money, after all where does your salary come from? not from the goodness of their hearts...comes from profits. Even NoN profit facilities must make money to continue to operate and provide service. STOP DEMONIZING THE MAKING OF MONEY!!

bestblondRN · May 10, 2001

I agree that a hospital CEO's salary is absolutely obscene when you consider the following:

I always ask myself what the "intinsic value" of certain personnel are to the mission a hospital is trying to accomplish. So, if the goal or mission of a hospital is to provide an excellent standard of care, blah, blah, blah.....then the next logical question is:, "Who will provide that care?" This, of course, leads us to the care providers, both nursing and non-nursing (and that includes medicine). Physicians couldn't do their jobs without nurses, nurses couldn't do their jobs without NAs, unit secretaries, respiratory therapy, P.T., etc., who couldn't do their jobs without nursing, and on it goes.

What it comes down to is that the most valuable employees in any healthcare organization are it's direct caregivers--in whatever discipline. What is the value of the CEO to the organization in terms of the mission and goal of providing a high standard of care? Do they contribute to that end? If so, how do they contribute? I am not suggesting that a hospital should go without administrators--you need them to keep things on track with the regulatory bodies, etc., but what I am saying is that I question the overall importance of a highly paid CEO in relation to the professionals and non-professionals who are responsible for directly meeting the goals of the organization.

I have always believed that a group of healthcare professionals (and the CEO should be a nurse who has some vision) should organize themselves and buy a hospital somewhere, and create a true patient-centered organization. In that process, the "wealth" should be distributed among the employees and re-invested into the system--not awarded to a figurehead who happens to have a MBA and can afford an expensive suit. I think an organization that is more lateral and rewards the bedside/direct caregivers will have the greatest chance of success in the managed care environment and in recruiting and retaining the most qualified staff. Obviously, this is over-simplified, but I really think this is the answer to some of healthcare's dilemmas--shift the power base from the businessmen to the healthcare professional. I think things would change drastically.

OK--time to wake up from my dream--thanks for indulging me

natalie · May 10, 2001

Dplear,

I'm not demonizing the making of money, I'm demonizing the unethical SPENDING of it in the healthcare field. Who says it should be a business??? Do you call your patient a customer?? (Hope you didn't buy that one when it came out.) Market-driven healthcare is one of the root causes of the downward spiral.

http://www.managedcaremag.com/archives/0006/0006.compmon.html

http://www.managedcaremag.com/archives/9905/9905.compmon.html

As for CEO's being replaced every day (and Oh dear, take a look at their compensation packages)do you have any qualms about the nursing staff that was dismissed in the last decade? Stockholders can vote in a public company as they wish. There is nothing wrong with capitalism. However, when the honorable, ethical model of a society tending to it's ill goes down the tubes in the name of "business", that society will decline. As we are so doing.

I play the stock market. But oh, don't get me going on business and medicine.

You deem 3 million/year as appropriate for a HOSPITAL corp. CEO. I call it obscene. The operative word here is HOSPITAL!!!!

Chellyse · May 10, 2001

While I must agree the responsibility level is intense for an admin or CEO. Part of the major requirements is to ensure quality of care and adequate staffing. If a CEO or ADMIN is making more than 300,000 a year that is TOO MUCH!!!!Especially in light of the staffing of the facillity they are working for profit or non-profit.In one state a citizens watchdog group is intervening with a local CEO who secretly increased his salary 43% from a base of 320,000 albeit this gentlemen has held the position for 18 years, this is still outrageous.If a management salary cut makes the difference in providing quality care to patients by allowing the budget to hire more staff,then so be it I say.Here is the example of job responsibilities.Oh and take a look at the projected increase in the job market 31%.

THE JOB

HOSPITAL AND HEALTH SERVICES ADMINISTRATORS are responsible for overall

management of health services centers. Following policies set by a

governing board of trustees, administrators plan, organize, direct, control

or coordinate medical and health services in hospitals, out-patient clinics,

convalescent hospitals, drug-abuse treatment centers and similar long-term

care facilities.

Administrators see that health services centers operate efficiently and

provide adequate medical care to patients. Their responsibilities are

varied and usually require the cooperation of assistant administrators and

the medical and support staff. Administrators of large centers act as

liaisons between governing boards, medical staff, and department heads and

integrate the activities of all departments into a smooth-functioning whole.

Their job is difficult and demanding; they need to keep up with advances in

medicine, computerized diagnostic and treatment equipment, data processing

technology, government regulations, health insurance changes, and financing

options.

Administrative functions include the following: planning and coordinating

departmental activities, program evaluation, development of policies and

procedures for various medical treatment and preventative activities,

quality assurance, patient services, and public relations activities such as

active participation in fund-raising and community health planning.

Administrators also direct the recruitment, hiring, and training of

personnel. Other activities include fiscal operations such as budget

planning, accounting, and rate-setting for health services. In addition,

administrators develop and expand programs and services for scientific

research, preventive medicine, and medical and vocational rehabilitation.

Large health services centers are run by chief executive officers (CEOs) who

assign work to assistant administrators to operate specific departments such

as physical therapy, personnel, and training or surgery. In small

facilities, the administrator is in charge of all departments.

WORKING CONDITIONS

Health Services Administrators often work long or irregular hours. Health

care centers operate around the clock seven days a week, and the

administrative staff may be called upon to solve emergency problems at any

time. Medical staff meetings, health planning councils, fund raising, and

professional association and educational activities all may demand extra

time and travel.

Health Services Administrators may join the American College of Healthcare

Executives. Administrators with experience in fiscal and financial

planning may join the Healthcare Financial Management Association.

EMPLOYMENT OUTLOOK

The following information is from the California Projections of Employment

published by the Labor Market Information Division.

Estimated number of workers in 1993 14,660

Estimated number of workers in 2005 19,160

Projected Growth 1993-2005 31%

Estimated openings due to separations by 2005 4,560

(These figures do not include self-employment or openings due to turnover.)

Employment for Health Services Administrators is expected to grow at a rate

faster than the rate for all other occupations in California.

Opportunities will be best in major medical centers and in large public

hospitals. Specialized centers that are care givers for older people or

those who may need care more frequently and for longer periods--such as

hospice programs that treat terminally ill patients--will also provide

jobs. Health maintenance organizations (HMOs) that provide care to a large

membership covered by health insurance are increasing in numbers and will

have an ongoing need for administrators at various levels. Opportunities

may be limited in the rural area of the State.

WAGES, HOURS, AND FRINGE BENEFITS

Salaries of Health Services Administrators may vary greatly, according to

the type, size, and location of the hospital and the administrator's level

of responsibility, but the California median hourly wage for this occupation

is $23.35. Assistant administrators can earn over $7,000 a month. They

usually have a bachelor's or master's degree in public health or health

administration. Some have a master's degree in business and finance.

Experienced administrators with a master's degree in health services

administration (or related) can make as much as $9,000, or more a month.

CEOs can earn as much $210,000 per year or more. Public health services

centers and smaller facilities usually pay the lower wages.

Fringe benefits usually include vacations, holidays, and sick leave;

medical, dental, vision and life insurance; and retirement plans.

ENTRANCE REQUIREMENTS AND TRAINING

Health Services Administrators should have a master's degree in health

services administration from an accredited college or university.

A master's degree in public administration or business administration may

also qualify graduates for entry into health care administration. The

health services administration degree usually includes a one-year internship

(residency) in a health care center. Graduates with a BA degree in this

field may work in a health care center before starting a master's program.

Nursing home administrators need to be licensed by the Nursing Home

Administrators State Board of Examiners to work for health care facilities

that receive Medicare or MediCal funds.

High school students who plan careers in health care administration must

take college preparatory courses, including biology, chemistry, advanced

math, speech, and economics.

Hospital Administrator candidates are evaluated by the board of trustees who

assess their performance in previous positions or situations. Skills that

rank high are organizational and planning abilities, leadership and

knowledge of business principles. They also look for such talents as

skillful interaction with individuals and groups, the ability to evaluate

and utilize facts and figures, and the ability to work long hours, often

under stressful conditions.

ADVANCEMENT

Health Services Administrators normally start as administrative assistants

in large centers or assistant administrators in medium-sized institutions.

They advance by taking increasing responsibilities such as associate

administrator and, finally, CEO. Moving to a higher classification may

require transferring to a smaller State.

Some administrators of small facilities may choose to accept a lower-level

position in a larger center which often leads to professional growth

:) :)

Chellyse · May 10, 2001

As you notice along with these grandiose salaries the requirements as mentioned before are not in medicine or healthcare for that matter. This article written in 1999 describes exactly that, we are paying business men unrealistic monies to mismanage or hospitals. It is an OUTCRY>

Hospital Deaths and Medical Errors (OUTCRY Magazine #10)

The report which came out in late November, 1999 regarding 98,000 hospitalized patients died each year in the Unites States due to errors was very shocking, but was not unexpected. According to the report by the Institute of Medicine, many of the mistakes were due to "basic flaws in hospital operational system." For example doctors poor handwriting was one of the problems cited resulting in some patients' death due to the dispensation of the wrong medication or wrong dose.

Although the report is applauded for exposing serious problems in hospital operation which is far more than physicians bad hand writing, but was inaccurate in some other ways. Contrary to what was said regarding health care being behind regarding advancement in technology, health care had led the way in computerization of hospital system and utilization of complex diagnostic machines even before Internet was born. What went wrong was more than just bad physician's handwriting.

What Went Wrong in Hospitals

Hospital was based on authoritarian method of administration for years because the professors always know more than the students regarding the subject matter. However, hospitals pushed the situation too far when business managers replaced clinicians in making medical decisions and patient's deaths start to rise. Many professionals who complained about the systems were directly and indirectly showed the exit door of the hospital. Subsequently, many hospital professionals left and took their experiences with them to other industries. Hospitals were left with inexperienced professionals to do dangerous work and cater for patients. What do we expect as the outcome? It was more obvious when many hospital across the nation replaced the judgment of the business manager who has never attended any medical school or had any medical training as the final say in hospital operation because of the demand for more profits. Consequently, many of the business managers made bad decisions which cost patient lives.

Hospital were Warned, but Refused to Listen

"The basic problem was, when a clinician was removed from heading a clinical department and replaced with a non-clinician, the essence and purpose of medicine were defeated.

"Today with new trend to modify health care delivery system, if the hospital process of administration is not overhauled and monitored, whatever system put in place is doomed to fail. page #90

"Removing a physician from heading a medical department like the laboratory is the error many hospitals across the nation would make. This malaise would grow like wild fire in hospitals ruining the health care to the point of economic disaster." page # 92

The above quotations come directly from the book Overcoming the Invisible Crime 352 pages, 1993 by 'Yinka Vidal, published by Lara Publications. This is the biography of a former hospital manager discussing some of the dangerous situations leading to many preventable patient deaths. Chapter four (pages 74 - 108) chronicled many situations leading to tragic consequences within the hospital. Vidal has been warning the system since 1993 when the book was first published, but they were not listening and so patients continue to die.

Solutions to Hospital Systemic Problems

Hospital must utilize the knowledge and experience of clinical experts to solve systemic problems within the establishment. At no time should a business manager be allowed to over rule a physician or a clinical expert. However, for the intervention to work, both business managers, physicians, nurses and other allied health professionals within the hospital must come to the bargaining table. In addition, interdepartmental committees should be set up to solve systemic problems incurred between the departments.

Critical evaluation should be made of how many patients a nurse or a physician can handle within a period of time. Similarly, how much work is expected of pharmacists, X-ray or lab techs before putting them under undue stress causing errors. It is well established that the more stress is generated due to work over load, the more the errors to be expected. When such errors happen patients die!

Hospitals must end the system of autocracy and be replaced with employee based solution interventions and strategies. Most hospitals who have adopted this style of management have experienced a boost in employees' moral and better work performance. It removes the "us against them" (administration) mentality and is replaced with "the contributing me" as part of the system.

Finally, patients themselves must be educated about their illnesses and be a part of the treatment with the physician. No patient must receive blind treatment without knowing the purpose, intended outcome and the resolution. Patients who accept blind treatment put their lives in grave danger. Click here to read more about patient's education

Man is by no means perfect and neither is any system created by human endeavors. Patients will occasionally be victims of human imperfections, but if we work hard to fix the systemic problems and not point accusing fingers, we in health care industry can reduce deaths from hospital mistakes. Is the hospital administration ready to listen?

Start patient education, get a copy of the book, Overcoming the Invisible Crime (Lara Pub. 800-599-7313). Here is a response to the book by a journalist: "A heart-rending story" Diane Sawyer, Primetime Life, CBS News.

cmggriff · May 11, 2001

I would take the man's job for a year. Pay me my 3 mil and fire me! Go ahead.

Mijourney · May 12, 2001

Hi. I'm not opposed to making money, I'm opposed to exploitation. Health care should be a right and not a share or stock.

I'm sure that non-specialist physicians would love to make 3 million dollars for all that they have to do. I personally wouldn't mind even making half of that. I just don't buy that it's necessary to make a killing to manage a facility. I've never been a CEO, but I would imagine that the most important parts of the job would be the ability to conduct a meeting, hire good administrators, delegate, and talk a good talk. Frontline nurses have to be able to do the same, with the exception of hiring, albeit with family, physicians, and other staff.

Therefore, it's perfectly justifiable for nurses and other direct bedside caregivers to demand more compensation for what we do.