Doctors across America are getting strikingly similar messages from their hospital administrators—that we are highly valued, but that they will reduce our salaries due to the pandemic. Whether you are working on the frontline and risking your life (and your family’s health) with limited PPE available (and indeed locked up and rationed), or whether you are soldiering on in the outpatient clinics. Your salary is going down, whether you signed a contract and moved across the country for the higher salary to help pay off your med school debts, or whether you’ve been comfortably working for the hospital system for the last two decades but now you have kids in college (and those fees are not going down). They tell us that they appreciate us, and our work. And that they support our well-being, and that we should exercise self-care. Which would be a lot easier if we were actually valued and our salaries paid in full as per our contracts. Some friends have learned of salary cuts from the news breaking the story—before their hospital makes announcements. Others of us have had our own vacation time or sick time balance taken away to allegedly help fund our salaries. During a pandemic where we are on the frontline and could get very sick? Some of us have lost the contracted hospital contributions to our retirement funds. Really? There are federal stimulus payments. We have been quietly accepting broken contracts because at least we’re getting paid most of what we expected. But medical jobs have always been stable compared to other fields—possibly part of why our parents encouraged us to be doctors in the first place. We have spent years of denying ourselves for the delayed gratification of these jobs—all the while developing mountains of debt. We are lucky to have jobs when people in other sectors are losing them. Does that permit administrators to help themselves to hospital bailout money, as recently reported, while trying to make us feel guilty about having jobs? Administrators write in their hospital-wide emails that they too are taking lower salaries; recent news stories have, however, enlightened us about the meaning of these pennies in light of administrators’ other enticements. Their silver tongues say that we are heroes, warriors, champions of health care. But they’re happy to accept the government silver on our behalf. Something is very wrong here. American health care being for profit is what encourages this behavior from the top. Governors prohibited elective surgeries for public safety. But elective surgeries are a cash cow for hospitals, and canceling them leads to decreased revenues. Alternatively, in a national health system where surgeries are done when they are needed for the health of the population, there is not such a cow in the first place. I have practiced both in America and overseas, returning from working abroad recently. Coming in with a fresh view, I was struck by the backward nature of our fee-for-service practices despite touting how important prevention is. There is so much negative talk about national health care systems from people who have never experienced them, much less worked in them. In contrast to the US, our colleagues in the rest of the world who have been on the frontline of fighting the pandemic are not experiencing salary cuts. They signed contracts for salaries and wow, they are actually getting paid their salaries. National health systems lack the mushroom cloud of hospital administrators and CEOs. Countries with national health care are actually putting their money where their mouth is in prevention. The ounce of prevention being worth a pound of cure is actually what saves the dollars in national health care, as well as saving the population. But on a larger level, public health decisions in systems with national health care actually are decisions about the health of the public—never more important than in a pandemic. We’ve just seen New Zealand (which has a national health system) open back up on June 8th—with no new cases in weeks due to their public health and government response. Around the world, people bang pots and pans at designated times to thank health care workers and show their support. Other places, this is not in lieu of our full salary. The author is an anonymous physician. Source
