Wow! This reply was a real pick-me-up. We (Trauma/CC) often feel taken for granted and "K" has certainly put our skill sets into perspective. I feel better about myself already!<BR> <BR>Jeff Hammond <BR><BR>----- Original Message -----<BR>From: KMATTOX@aol.com<BR>Date: Tuesday, December 4, 2007 8:51 pm<BR>Subject: Re: Call responsibilities<BR>To: trauma-list@trauma.org<BR><BR>> <BR>> In a message dated 12/4/2007 6:09:05 P.M. Central Standard <BR>> Time, <BR>> rgross@harthosp.org writes:<BR>> <BR>> Ken,<BR>> <BR>> When can I start as an attending on your service - it <BR>> might take me a day or <BR>> so to move, but I am available after that! ;-)<BR>> <BR>> Ron<BR>> <BR>> <BR>> <BR>> <BR>> Ron: Thank you for volunteering to be a faculty with <BR>> us. We are not at <BR>> the level of understanding or support that I cited in my <BR>> letter. I wanted to <BR>> share with this list server what is happening across the <BR>> country, often <BR>> quietly. I am aware of at least <BR>> one hospital that is paying surgeons and <BR>> neurosurgeons $5000 per 12 hour shift to take call from <BR>> home. FROM HOME. <BR>> <BR>> The numbers and principles I cited are probably LOW compared to <BR>> the VALUE to <BR>> the rest of the hospital and especially to the rest of the <BR>> surgical <BR>> services. It is important that every acute care, <BR>> emergency, trauma, general surgeon <BR>> understand their worth, leverage, and benefit to patients <BR>> and the rest of <BR>> the health care enterprise. DO NOT <BR>> UNDERSELL yourself or allow yourselves <BR>> to be USED. <BR>> <BR>> You have many values and benefits to patients, other doctors, <BR>> hospitals, and <BR>> to society. <BR>> <BR>> 1. Your TIME is very valuable. <BR>> Your "call pay" is to pay you for YOUR <BR>> TIME, just as lawyers, and many other professionals are <BR>> paid for their time. <BR>> You get paid just for being there. <BR>> PERIOD. You should never do this <BR>> physical presence just for free. <BR>> The value for this time for the many things <BR>> you do for the community, hospital enterprise can be estimated <BR>> and supported <BR>> to be from $100.00 to (in some instances) more than <BR>> $300.00 per hour. Your <BR>> hospital administrator knows that very well from his <BR>> allocation analyses. <BR>> The CFO of your HMO knows your value very very well, they <BR>> just do not want <BR>> you to know as most acute care, trauma, emergency, general <BR>> surgeons have <BR>> allowed themselves to be painted into a corner and forced <BR>> to accept a far too low <BR>> stipend. <BR>> <BR>> 2. Your SERVICES and EXPERTESE are becoming <BR>> very rare. The number of <BR>> acute care, emergency, trauma, general surgeons who <BR>> are very comfortable and <BR>> effective in an open neck, chest, abdomen, or groin is <BR>> decreasing daily. <BR>> This person is the bedrock of the medical establishment of <BR>> EVERY community. <BR>> For a community to not have such a person, is a very <BR>> unfortunate community. <BR>> Your payment for these services can calculated many <BR>> ways, AND MUST NOT <BR>> EVER BE DISCOUNTED or compared to simpler laparoscopic or <BR>> endoscopic or <BR>> uncomplicated technical repetitive <BR>> tasks. The fee schedule for these <BR>> services is <BR>> more like the fee for services amounts of the 1980s than the <BR>> double <BR>> discounted Medicare level, $0.30 on the Dollar voodoo health <BR>> payments of HMOs, <BR>> government plans, and salary arrangements. <BR>> <BR>> 3. Your understanding of SYSTEMS approaches <BR>> and DISASTER availability to <BR>> your community is unparalleled. You are the <BR>> foundation of survival. This <BR>> fact is well known by your local EOC and stage <BR>> agencies. NO ONE ELSE but <BR>> you are literally available 24/7 for the entire community, <BR>> and can do <BR>> everything needed for such responses and as history has <BR>> shown, have been there when <BR>> society and civilization needed you. <BR>> <BR>> I am so proud to know so many of you who are among the best <BR>> clinicians in <BR>> the world. I would be happy to hire many of <BR>> you, but in a different battle, <BR>> the money available to physicians may be sparse for the <BR>> next few months. I <BR>> have drawn a line in the sand regarding the proposed <BR>> Congressional Medicare <BR>> cuts of 10.1% to physicians and have many other physicians <BR>> nationally that <BR>> have made the same personal decision and communicated such <BR>> to Congress. I am <BR>> sick and tired of the perennial charade of doing at the <BR>> edge adjustments of <BR>> partial fixes of the proposed Medicare cuts by congress <BR>> only to discover that <BR>> the payments to doctors continues to decrease, while every <BR>> other payment <BR>> from Medicare increases. <BR>> Obscene. <BR>> <BR>> SO, I have stated that I am opposed to ANY <BR>> congressional "fix" to the <BR>> proposed 10.1% Medicare payment to doctors. Just <BR>> leave it where it is and let <BR>> the chips fall where they may, and let everyone let CMS <BR>> know just how broken <BR>> the system really is. If <BR>> these issues were in my hospital, it would <BR>> immediately be declared a sentinel event and a search for <BR>> a root cause would be <BR>> screamed. <BR>> <BR>> Kenneth Mattox, MD<BR>> Houston<BR>> <BR>> <BR>> <BR>> **************************************Check out AOL's list of <BR>> 2007's hottest <BR>> products.<BR>> (http://money.aol.com/special/hot-products-<BR>> 2007?NCID=aoltop00030000000001)--<BR>> trauma-list : TRAUMA.ORG<BR>> To change your settings or unsubscribe visit:<BR>> http://www.trauma.org/index.php?/community/