Friday, August 7, 2009


Another word for SERMO. Dan Palestrant (founder of Sermo) was on for another ‘debate’ with “established’ organized medicine. This time it was with the head (/Dr. William Struck ) of the Bassett Hospital in Cooperstown, New York. The argument again was about ‘salarizing’ physicians as a means of cost containment.

Viewers of this ‘sound byte’ need to know about Bassett Hospital.. Bassett Hospital operates in a rural area of Northern New York. It is a pristine small community with a fairly large drawing area of a lightly populated region. Solo private practice in that communitiy would be untenable economically. Bassett Hospital also is affiliated with Columbia University School of Medicine, and has multiple training programs for residents from Albany Medical Center (over 100 miles distant) and also from Columbia University in New York City, over 200 miles distant.

This is a unique population of physicians and their practice setting. The presence of residents in training (who are salaried at a much lower level than attendings) shifts a great deal of work load, night call and physician administration, such as record keeping to junior physicians who are not yet qualified to practice independently..

Attending physician work load in this setting is diminished when compared to other settings. The lowered physician income does not decrease overall costs, and any benefit is shifted to the administrative staff, capital expenditures, and operating budgets. Physician income is a very small component of their budget. (so is income for physicians not in integrated health care systems.)

When asked, the CEO of Bassett hospital dodged the question from about how much savings there were by salarizing their physicians. I suspect this was because he either did not know, or would not admit there are “NO SAVINGS” overall.

Dr Struck contends that salarizing physicians removes the added administrative tasks from physicians and allow them to focus on their patient care. This begs the question and denies the culpability of the insurance industry and regulatory affairs that has imposed these tasks upon the physician. It puts the horse before the cart and attempts to make physicians responsible to reduce the cost of this burden imposed by insurance and government payors.

Dr. Palestrant and Sermo join other real physician advocates in their proactive and aggressive education program for the general public.

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