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New survey data on compensation

October 2010

Published in the October 2010 issue of Today’s Hospitalist

Lower base salary results in higher compensation

SURVEY DATA RELEASED by the SHM/MGMA last month found that hospitalists who have lower base salaries as a component of their total income have the highest levels of both compensation and productivity.

According to 2010 survey figures based on 2009 data, hospitalists receiving 50% or less of their compensation from base salary had the highest median level of wRVUs: 5,407. By contrast, hospitalists whose base salary accounted for between 51% and 70% of total compensation reported 4,591 wRVUs; those with 71% to 90%, 3,859 wRVUs; and those with between 91% and 100% of their total compensation as base salary logged 3,571 wRVUs.

Both hospitalists who worked in groups that weren’t hospital-owned and those who provide on-call coverage at night (vs. onsite coverage) reported higher productivity levels. The median compensation for internal medicine hospitalists in the survey was $215,000; $218,066 for family medicine hospitalists; and $160,038 for pediatric hospitalists.

Interventions eliminate MRSA postop infections

THROUGH A SERIES OF INTERVENTIONS, researchers at Rochester General Hospital were able to reduce the incidence of MRSA infections in patients after cardiac surgery by 93%. Interventions included preoperatively screening patients for colonization; giving IV vancomycin to carriers; administering intranasal mupirocin to all patients for five days beginning one day before surgery, regardless of their colonization status; and applying mupirocin to sites as patients’ chest tubes were removed.

The study, which was published in the Sept. 13 issue of Archives of Internal Medicine, compared MRSA wound infection rates for three years before and three years after the interventions were introduced. The authors found that overall wound infection rates dropped from 2.1% before the interventions to 0.8% after.

Before the interventions were introduced, researchers wrote, MRSA accounted for 56% of the hospital’s postop infections. The interventions did not, however, change the hospital’s rate of infections following noncardiac surgery.

Depressed med students afraid to seek treatment

MORE THAN HALF OF MEDICAL STUDENTS suffering from moderate to severe depression are afraid that they’ll be judged as inadequate if they seek treatment. According to the results of a Web survey published in the Sept. 15 issue of the Journal of the American Medical Association, significantly depressed medical students thought their peers would question their ability to perform if they talked about their depression.

Researchers found that 14% of the medical students they surveyed were moderately to severely depressed, and that those students considered dropping out of medical school more than their peers. Authors also pointed out that more medical school students report depression than the general population.

An accompanying editorial pointed out that interventions were needed for depressed medical students, particularly those between their second and third years, to address suicidal thoughts (present among 4.4% of the sample) and to prevent students from leaving school.

Judging doc quality: not much for patients to go on

A NEW STUDY CLAIMS that the available public information about physician quality “educational background, malpractice claims history and certification status “doesn’t strongly correlate with quality of care.

Researchers from the University of Pittsburgh and RAND Health looked at claims data for 1.13 million patients in Massachusetts to calculate performance scores for those patients’ physicians based on 124 quality measures. (More than 10,000 physicians were in the sample.) Factors associated with higher performance included female gender, a U.S. medical school degree and board certification.

However, those factors were associated with only slightly better average quality scores. (Malpractice claims were not associated with any performance differences.) Authors concluded that publicly available data on physicians are “poor proxies” for reporting performance on quality measures.

Of the three types of available data, the one most significantly associated with higher quality scores was board certification. The authors concluded that their findings might serve as “preliminary evidence” that certification is linked to higher quality care.