What Does it Mean to be "On Staff?"
 Richard L. Baron, M.D. |
Medical centers have faced economic pressures over the past 30 years—driven by competitive market forces and managed care to reduce costs—but have maintained ever-increasing productivity and profits. Now, amid the worst economic downturn in recent history, medical centers face pressures similar to nonmedical businesses—decreasing volumes as patients defer elective spending, increasing bad debt from unemployed, uninsured patients and delays in third-party payor reimbursements. Further compounding these issues are endowment values decreased by as much as 30 percent, further reducing needed income.
Rather than bemoan the lack of funding for new equipment or expansions, or the possibility of limited salary increases, radiologists must keep a balanced perspective. We remain well compensated with gratifying daily activities. We can treat patients and teach residents without compromising quality. We positively influence morale by choosing not to focus on the negative which affects our technologists, nurses and staff who historically are at greater risk in economic crises. As physicians, we are leaders of the healthcare profession—the very word "care" implies a priority of caring for our patients, colleagues and staff.
Physicians must also care about the needs of their institutions rather than being complacent. I remember a disturbing conversation a decade ago with an internist employed by a soon-to-be-bankrupt hospital system. Discussing how managed care was challenging medical practices, her response was, "Doesn't affect me—I'm on staff." She assumed her paycheck was guaranteed no matter what the financial status of her institution. A few months later not only was her employer bankrupt and she unemployed, but also her pension was lost. So much for her concept of being "on staff."
Used differently, "on staff" can express pride—pride in being affiliated with a facility known for providing excellent care or education. Such organizations will remain strong and maintain their reputations only if all physicians understand institutional needs during difficult times and promote needed actions. By being proactive in supporting the success of our practices and entire institutions, we can truly be "caring" healthcare providers.
