February 16, 2010

A note on doctors' salaries ...

At some point in this story about Wheaton-Franciscan, someone is going to start looking into local physicians' salaries. I know, because we've started to do so, and other media isn't far behind.

But before we rush into public outcry over the millions or hundreds of thousands of dollars doctors make, it's worth noting a few things:

1.) Doctors are paid based on their billings. A doctor who makes $1 million dollars a year generates five to six times that amount of money for a health care provider. That's why they get big salaries - they bring in big dollars.

2.) Doctors spend 10-plus years in school racking up massive debts to become doctors. Not that we need to feel sorry for them, but doctors do provide a skill most of us cannot. As a result, they get paid more. Whether that's fair or not is a different story and debate.

3.) Every doctor makes mistakes, and some of those mistakes lead to death or further injury or illness. It's part of the business.

I bring all this up because the issue of doctor pay is going to come up soon. Two local doctors made over $2 million in 2008, making them the highest-paid employees in Wheaton-Franciscan.

By comparison, All Saints' top administrators make somewhere around $500,000 a year. It's all an insanely high amount of money, and the reflex will be to question why anyone needs to make that much money.

My hestitation in calling doctors or administrators out on their salaries is, well, they're the people who keep people alive. Maybe they don't do it as well or as efficiently as we'd like, but when it comes down to it, I want a well-paid, talented doctor seeing my friends and family members. It's something I wouldn't want Wheaton-Franciscan, or any provider, to skimp on.

But no doubt the bomb is coming on "so-and-so" made this, and "so-and-so" made that. We're ready to jump in the fray with lists of top-paid doctors and executives. Hopefully we can put at least some of the numbers in some sort of perspective.

In the dispute between Wheaton and its doctors, no one needs protecting. But I'm afraid it will be easy for the community to get distracted from the bigger picture, which is the quality of health care in Racine. It's an important debate - one our lives' may well depend on. Let's hope we don't get distracted by dollars and lose sight of common sense.


  1. The issue shouldn't be what doctors make, it should be that admins, some with online Master's in education and MBAs from the University of Phoenix, make anything close to those doctors -

  2. My husband has been a physician in this community for 20 years..16 years in private practice, 4 years as an employee of All Saints. He earns a lot because he works a lot. He has four years of college, four years of medical school and five years of residency under his belt. He was almost 30 years old before he finished his training. He is in a high demand subspeciality and Racine., in my opinion, is very lucky to have him. He has worked extremely hard to care for and advocate for his patients over the years. We believe that to whom much has been given, much is expected and both of us have worked tirelessly to give back to our community in many different ways. We are tired of fighting Wheaton over everything from inept billing/collection processes to providing patients with medication samples. If this whole issue of Wheaton's poor management turns into an uniformed attack on physicians and whether or not they earn what "they deserve" then the people are not seeing the forest thru the trees.

  3. I know a number of highly paid doctors in and outside of Racine, and the one thing they share in common is that they are among the hardest working people I know. Furthermore, they make more personal sacrafices than almost any class of workers in America. The beauty of this country is that if you're good at what you do, you make great money and you get to live in a big house. If you're not good at what you do, you won't live in a big house or at least you won't for long. I applaud the doctors who have managed to stay financially successful for long periods of time. May we fortunate enough to have more of them in our town!

  4. I don't have a problem with my highly trained, dedicated DOCTOR making 2+ million a year for saving lives.

    What I DO have a problem with is professional athletes that make MORE just to entertain.

    Just doesn't seem right.

  5. It should at least raise an eyebrow that the core of the Wheaton issue was the pay decrease. We can feel all warm and fuzzy about the doctors taking a stand, but this story has been short on hard, tangible facts - with the exception of billing and anesthesiologists.

    I just can't get past the fact that those issues don't seem to justify walking out. You're talking about a total disruption of your life, relocating (potentially), giving up your practice with your established clients (at least for 18 months), putting other employees jobs at risk, and possibly bringing down Racine's major hospital.

    Because of billing?

    Sorry folks, but I can't believe money isn't playing a bigger role here than the doctors are making it out to be. They are downplaying it as much as Wheaton management and the JT is playing it up.

    Something about this doesn't feel right to me.

  6. Dustin,
    You sound like a commie when you "question" whether anyone needs to make that much money.

    It's none of your damn business.

    Leftie jealousy. That's all it is and all it ever was and all it ever will be.

  7. My husband is a very hard-working doc and I can say that 98% of the doctors do not make anywhere near 2 million dollars/year. Most don't even come close to $500,000/year as the administrators do, for far less work and less training, in my estimation. The average salary of Racine physicians would probably be less than you would think.

  8. If we start to question what the administrators at All Saints make, then lets start to ask about SCJ, Modine, Racine Federated, A & E, and on and on.

    Doctors do deserve what they can get paid...if it is by and because they were a benefit for their patient. But CEO's of major corporations also deserve to get paid. If you don't agree, ask Fisk to take a cut so your housing cleaning products are cheaper. I am sure he gets paid more then the front line person who makes it.

    Keep the focus on making things right. Do not throw money at the problem. Fix the billing. Fix the other stuff. Let administrators and the doctors do their jobs and work this out.
    Now that there seems to be some progress in talks, those hellbent on making a stink will continue to say they do not like what WFH is doing. It has been a week since they last met. It will take time to fix things.

  9. While we're at this doctor and administrator pay stuff, let's ask for the publicaly avaialble information on Aurora, another local organization, Froedtert, where people from Racine say they want to go, and other places.

  10. Anon 5:53 - yes, we should ask what admins make at all of these places. Why does the team that designs the box to put the drugs in make far more than the scientists who discover, develop, validate and maintain those drugs? Why should admins be able to get a night degree (or worse) to advance their careers (because they are SO busy witgh work and family life) yet the R&D folks need to have lots of degrees and experience to even be considered for a job? Why should physicians who follow all the rules have to look over their shoulders at lawyers and end up settling ridiculous suits because it is cheaper in the end to do so?

    Peopl eget rich in their marketing, sales, admin of wahtever jobs, then someone gets cancer and you hear the wailing and gnashing of teeth if they are told nothing can be done. Then they plead and call doctors and scientists at universities, pleading for answers. The answer is to go back and spend money on a whole bunch of didfferent people than you did . . .

  11. Anon 11:08, Dustin spent 90% of that post giving reasons why high doctor compensation is justified. Yet you call him a "commie" just because of a single line he added, likely just to acknowledge both sides of the debate?!?!?!

    This is example #1 of why I usually find claims of media bias quite comical.

  12. For example, the quote on the front page by "Jennifer Garbo Shawhan, Wheaton-Franciscan spokeswoman" is "we've made some pretty significant improvements."

    Great! With your degrees in "industrial orgainzation" or "effective awesomeness" you changed around scheduling and work flow in the hospital. Then you pretend that what you do is as difficult and creates value even remotely similar to a doctor cutting into a patient's chest or a nurse providing meds to a patient and patiently, intelligently explaining everything.

  13. Seriously, why is the subject of physician salary even an issue.

    Unless they are fraudulent in their billing practices i think they deserve every penny they get. Just like i think i deserve every penny i get from my job. You want the money go do the work. Note: If your going into medicine for the money, you're already making a big mistake.
    There is a long list of people that need to be looked at well before physicians. Politicians, athletes, bankers, brokers, corporate CEO's and the list goes on.
    I've worked in the healthcare industry for 25+ years, i know what they go through, i wouldn't wish it on anyone. Unless you have personal experience with they lives of a physician please dont comment. You are likely way off base.

  14. Again the Masters of Manipulation are hard at work. They "The Wheaton’s" are working very hard to make the Doctors be the problem rather than looking at how they can correct or own their responsibility to this issue.

    It's really about Poor Service and double Billing to the Patients and also holding our doctors Hostage by not allowing them to "Practice Freely" what they trained to do many years.

    Please Keep the focus where it belongs on "The Wheaton’s".

  15. Anon 6:14- For any tax-exempt organization (which includes all Milwaukee area health systems) the compensation information for the Board of Directors, Executives, and the 5 most highly compensated individuals in the organization are all reported on the IRS 990 form, which is publicly available. Try searching http://www2.guidestar.com or, for a site that doesn't require registration, try http://tfcny.fdncenter.org/990s/990search/esearch.php.

  16. One thing I found disturbing was the ala carte pricing they have set up with the doctors and based on what they generate they get a portion for wages. Does this lead to unnecessary tests? Does this lead to higher insurance costs? Does this lead to higher out of pocket expenses for the end consumer? If we want healthcare reform lets start looking at this as the first point of change.

  17. You are missing one very big piece of the puzzle - that is the malpractice insurance premiums the Dr.'s have to pay due to ambulance chasers and no cap on lawsuits. Theses can cost in excess of $50,000 depending on the specialty.

  18. Take a look at this link to educate yourself further on what physicians go through.


  19. The JT printed the salary not for comparitive reasons. They did it to smear and discredit a doctor.


    I can understand if you were doing some analysis of pay in the area compared to other places, etc. I think that is a legit part of the story, but that sure is hell isn't what the Journal Times did.

  20. I wonder if this might be different if there was another local hospital in competition with these guys...

  21. The Journal Times works for W-F. They are the paper's largest advertiser. That's simple - money trumps human lives. Always has. We just don't like to admit it in public.

    The Journal Times takes money from the community and sends it to Lee Enterprises. The hospital takes money from the community and sends it to W-F administrators.

    Oink. Oink. Oink.

  22. For the Urinal Times to go after and dig up doctor's salaries is pretty shady. The problem with with Wheaton and its failing management, etc. Not the doctor's. Someone tell the Urinal to take a look and read the comments form the readers on this outlet and their own.

  23. As someone who's spent the last 23 years working with surgeons and hospital admin, I have a different view; I don't think that the JT smears anyone buy posting what many believe is a physicians high salary. Pop Quiz: Your plan gives you a choice to choose from 3 surgeons: Dr. 1 makes $250K per year, Dr. 2 makes $950K per year, and Dr. 3 makes $2.4m per year. All 3 will cost you or your employer the same amount. Which do you choose? I'm going with Dr. 3, hands down. In today's medical paradigm, highly compensated means the same as very busy--very busy means very experienced--very experienced, as reported in the med literature, translates into fewer operative and post operative complications and improved outcomes. Patients know this, so if I'm a surgeon, I'd rather have my picture in the paper under the caption Dr makes $2.4 million rather than one that says Dr makes $200k, or, Dr is the lowest grossing specialist in his field. Unless that specialist is doing mission work in Malawe, he's not for me. As citizens of Racine, we should hope for a local hospital filled with busy and experience physicians.


  24. Folks -

    Let's take a fresh look at this. On one side, you have a "greedy" system with Mr. Oliveria. On the other side, yes, you do have some "greedy" doctors. Whether we like to admit it or not. Nothing will be good enough for either side.

    In the middle are many of the other physicians, local administrators and US - the patient.

    Might I suggest instead of bashing All Saints, let's try to help them fix it for us. Whether we go to Aurora or not. Because if we let All Saints close, we all lose. 3,000 = or - jobs gone. Home values drop. And on and on.

    I know from experience that if you have a billing issue, call the top. Yes, I too had an issue. Moved to Racine 6 months ago to work for SCJ. Had a medical issue. Received a bad bill. I called Mr. Buser. Left him a direct message after I spoke with a pleasant woman. Did not expect to hear from him. He himself called me the next day. To my pleasant surprise. Very pleasant man. He did not have all the answers and asked if an associate of his could look into my situation and call me. And they did the next day. Problem fixed.

    Can't say I want to go through that every time, so I offered some suggestions.

    Might I suggest each of us call or write to the leadership of the hospital and ask them to look into situations. Instead of all of us continuing to bash All Saints, let's offer some positive feedback to help them help us. The 3,000 or so employees try to do a good job for us. Let's help them. The doctors want to do a good job for us. Let's help them.

    Because in the end, if we lose many doctors or our hospital, we all lose!!!

  25. Ummm ... hate to break this to you, but there is something wrong with a doctor who makes $2.4 million while millions go without affordable health care.

    Now, I wouldn't have any trouble with a doctor who makes $2.4 million if and when everyone has access to health insurance.

    But until that day happens - like, when the health-care reform bill passes - yes, there is, indeed something very wrong with a doctor who makes $2.4 million a year.

  26. Put in what ever number makes you comfy, the point I'm making is that having access to what I'll refer to as "consolidator", is most often viewed as a very good thing. "Specialist" live in a world where the desease they treat or the procedures they provide are small by comparison to basic treatments. If there are 300 procedures performed annually in a particular market, then you or I would benefit greatly by having our performed by the person with the highest volumes. Clinical word of mouth, satisfied patients speads the word, and before you know it, the 300 cases are consolidated; care no longer provided by 6 physicians, but rather 2. Data, from almost any specialty or subspecialty, will support the fact that outcome improve. In my experience, an income outlier is usually a consolidator, don't know for sure that that is the case hear, but I'd be willing to bet it is. And as a prospective patient, I'm very OK with fewer doing more better, and consolidating both the cases and the salaries that would have gone to the less capable.

    As far as the health reform bill, I don't see it affecting this particular scenareo.

  27. Dustin and Pete, Keep up the good work. Looks like the Journal story on Dr Prpa backfired royally.

    I made my donation through paypal this afternoon to the Racine post. It made me feel damn good to do so. Hope it buys you at least a tank of gas!


  28. The way that the doctor offices bill patients is extremely flawed and open for fraud and corruption. Allow me to explain. When a patient goes to the doctor there is this print out where they make you sign the back of it. What you are signing is the billing form. You are agreeing to whatever they mark on the front of the page (ICD-9 Coding). You have a basic broken arm. They mark the specific code on the front and you are automatically charged for certain tests, materials, etc.. regardless if that material or test was run or not. Another example you feel like you have the flu but eating bad food can have the same symptoms. Because you never receive an itemized list of what was done you can't say.... wait... you marked that you treated me for the flu and charged me for a flu test but I never had a test done. But in order to truly say you have the flu you have to have a test. Instead, the doctors treat the symptoms... nausea, vomiting, etc. dianosis flu and you are sent on your way. I have been told on 2 occasions that I had the flu but was not once tested for it. I am certain I was charged for a test that I never received. I will never know for certain because it is not itemized. The trick is.. get an itemized list of what you are billed for.. good luck with that.. So if you are tempted to cook the books a little, this system allows for that. The doctors charge for services never rendered.. and the hospital administration and the doctors benefit from the billing system. Insurance companies then charge us more. Now not all doctors do this and I am sure most do not. But when an organization gets as large as Wheaton.. things can get corrupted. This just adds another aspect to this situation.
    I would also like to know what the mortality rate is of the hospital. I think the treatment and misdiagnosis there is terrible.. investigate that.. I don't care about their pay.. if they are good they deserve every ethically received penny!!I care about what kind of doctors they are. Just because you have M.D. behind your name doesn't mean you got spectacular grades... just sayin'

  29. Wellsprings really did a job on Wheaton but the alternative was not pleasant either. Perhaps some additional management overhauls would help. Accountability of the employees would help. Removing some key players that have crippled the ability of good leaders to do what it takes to make improvements would be a fantastic start. Start with the CEO and stuff will always roll downhill. It wouldn't take long for the new "guy" to figure out who needs to go. Small town, small pool to choose from. Too many "internal" people moving up the ladder with not a clue! Would love to see Wheaton stay and prosper, for the health of the community, for the health of my family.

  30. If our president and his soclistic views were to become a reality these doctors would get to share their incomes with those of you who have done nothing with your life. Yes I am sure many of you think that is a grand idea but where is the incentive for a gifted talented person to persue the high standards that they do.

    I say these doctors have earned their rights to earn any salary that they can. On the other hand the management (with a fraction of the education) Do not have the right to try to take these privleges away especially in the middle of a contract. For them to try to hold these doctors to a non-practice/non compete clause after reducing their pay is nothing but a downright theivery.

    Lets get with it management and and take the blame that is due to yourselves. You have run this place into the ground due to very poor management and now you want the money makers bail you out. This is cowardice.

    Milwaukee came in and took over and took all the profits of All Saints and squandered it in the Milwaukee losing market, and now you want blood from Racine.

    Many of this top management team need to take the blame and the consequences for what you have done. Generally running a company into the red is not considered good. Unless you are associated with the government.

    I for one hope the the Nunns will see what has been going on and start letting some heads role. The Franklin site should be good enough to let many high ranking people go find a new job.

  31. Anybody know the Email address of the Wheaton-Franciscan convent where the Franciscan nuns who own WFHC reside? It would be nice to inform them of the goings-on in Racine, and to get the perspective of the Mother Superior of their order on all this. Not to point the finger of blame at these dedicated women, but to make sure they know how their organization is viewed in the public eye. Maybe they could exert some "moral influence" on their regional CEO's business practices!

  32. Not to burst anybody's bubble, but let's interject a dose of reality here. Do you really think nuns in the Catholic Church are really in charge of anything?

  33. If a dr. makes over 2 million stop and think what WF makes on him...now wouldn't they hate to see him go elsewhere.

  34. Anonymous 7:32am: The subject of physician salary is an issue because this is the REAL reason the physicians at Wheaton are mobilizing. They've had their pay cut, and they now have quotas, "RVUs", they have to meet to earn their salary. The patient issues about Wheaton's unbelievably terrible billing, and patient care, are coming to light as a side story. Physician paycuts and RVU quotas have occurred at Froedtert/MCW as well the past couple years, so this is not specific to Wheaton. I don't know where they plan to go because it's no better for them anywhere else.

  35. So, the guy making $2million is actually billing $10-$12 million? Man, do the math on a per day billing. This is totally out of control. Who could afford to pay these outrageous rates? If "somebody else" wasn't paying the bill, the whole thing would come tumbling back to reality.

    The billings are obscene. It then follows that the salaries are obscene. When you figure the average wage of the patients at a Racine Hospital....it is no wonder that the average person can not afford healthcare.....

  36. Nuns are part of the organization for wheaton. We had to write a letter and appologies for not leaving a meeting room early when a nun wanted to get into the room early before her meeting. Per Ken Buser. This Nun was a VP from Wheaton.

  37. I have to ask the Question what about the management for Wheaton. I see alot of blogs about different managers and wonder if the adminastration of Wheaton will hear the concerns of the employees and the concerns they have about management.The two department I have read about the most are Women @ Infants and Materials Management.

  38. Mangagement has already said they would not listen to any comments on the post. You have to show up in person or write a letter or email with your name and specific grievence.

  39. So doctors, like Prpa make tons of money doing neurosurgery. Great that they're well compensated and also make money for the "man".

    Consumer beware. I heard that docs at Wheaton and Aurora may be really pushing surgery (for economic gain) before referring to alternate treatments. Spinecare at Frodert is a great alternative if a Wheaton doc says he has to cut soon. Too much risk involved without a second opinion. Oh, I forgot, Wheaton docs are not supposed to refer elsewhere.

  40. Must have been a kick in the pants when Aurora told you "No thanks".

  41. As we continue to address this issue of compensation to the doctors, I have to go back a couple of years. when Dr. Prpa treated my wife for a broken leg. He could have done the easy way and preformed surgery but instead told us he would treat her like she was at Mayo Clinic. This meant she would not have surgery and she would heal slower but her leg would be stronger. Well his method worked and she was able to return to her employment without any restrictions.

    So when you complain about his income lets look at his Skill Base. I would rather go to him for treatment then to someone who only knows how to cut.

    By treating my wife as he did he didn't generate as much money for the Hospital as someone else would have.

    I only hope that some day he will be able to open his own clinic.

    This man should be praised not criticized for making a good living.

    It took him many years of training to get where he is and no one should criticize him for this.