by Klaus Rohrich
February 1, 2005
While salaries for doctors in Ontario have been steadily shrinking, those of hospital administrators have been heading in the opposite direction. Information obtained by Canada Free Press shows that Ontario's hospital administrators are being paid extremely well. Here's an example of some of the salaries as posted on the Ontario Ministry of Finance's Salary Disclosure web site, listing all government employees earning in excess of $100,000 per year.
University Health Network's CEO T. Closson was paid a base salary of $650,333 in 2003 with an additional $62,457 in taxable benefits, which brought his total 2003 compensation to $712,790. That works out to just over $365.00 per hour.
Other examples include alan Gayer, the president of Toronto's Sick Children's Hospital whose 2003 remuneration amounted to a total of $610,764 or about $313 per hour. Mt. Sinai's Joseph Mapa's 2003 compensation exceeded $589,000.
This trend does not apply just to hospitals located in Toronto. Tony Dagnone, CEO of the London Health Sciences Centre was paid $486,000, while Kevin Smith, president of St. Joseph's Health Centre in Hamilton was paid some $460,000 in 2003. Even smaller, regional hospitals are following this trend. Northumberland Hills Hospital in Cobourg paid its CEO $169,000 or just over $1,380 per bed.
In contrast, general practitioners are leaving the profession in droves due in large part to the fact that their earnings are not keeping up with their expenses. One such practitioner in a letter to his patients explained why he was leaving the profession.
"To pay for rent, staffing and supplies costs me over $70.00 per hour. I do not have any health benefits, paid vacation or pension. What OHIP pays me to look after your medical care does not come close to what I should be receiving given my 11 years of university education, my work responsibilities and workload/complexity. Contrast this with the fact that dentists receive over $100 per tooth filling and a physical for your cat would likely set you back at least $120." (Emphasis added)
The myth that doctors are living off the fat of the land is just that- a myth. Successive Ontario governments have been so successful in stirring up class envy against doctors that the public seems blind to its own plight. as more and more doctors in Ontario are leaving their profession, there are no younger doctors to take their place. The majority of general practitioners today are in their 50s and rapidly approaching retirement age.
according to the Section on General and Family Practice of Ontario, a professional organization for general practitioners, there are 30 percent fewer medical students opting for the rigours and relatively low salaries of a general practice than there were 15 years ago.
The average visit to the doctor pays a physician between $17.30 and $28.50. a full annual physical, a procedure that usually takes upward of 45 minutes to one hour, pays a doctor a mere $54.10. Yet, family physicians in practice have to pay rent, staff salaries, equipment and utilities. Most family doctors work in excess of 60 hours per week and do not receive paid benefits, holidays or educational leave. One can hardly blame young doctors for not wishing to enter general practice, given the poor financial prospects they face.
Yet, this isn't the worst of it. Currently there are in excess of one million Ontarians, or about 11 percent of the province's population, who do not have access to a family doctor. The average doctor's patient load is in the neighbourhood of 2500. If as few as 400 general practitioners retire within the next year, the number of people without access to a family doctor in Ontario will jump to 22 percent, or nearly a quarter of the population.
Dr. anthony DeLuco, Chair of the Section of General and Family Practitioners of Ontario in a letter to patients recently wrote: "In the face of this crisis, our Premier, Dalton McGuinty, our Minister of Health, Mr. Smitherman, and your Liberal MPPs are telling you--our patients--that they can ensure your needs will be met by bullying family doctors…into accepting an ‘offer' which is offensive to our colleagues and has been rejected by the majority of doctors in Ontario."
It's a shocking juxtaposition: hospital bureaucrats earning upward of $365.00 per hour, while those actually treating the patients are not being paid even one-third of that. In addition, the bureaucrats have full benefits and no overhead, while family doctors have to cope with ever-rising costs of keeping their practice open.
This could explain why healthcare in Ontario is deteriorating at such a rapid pace, regardless of how much money the government pumps into the system. When the worth of an administrator exceeds that of a physician, in some cases by 400 percent to 500 percent, then there are some serious structural flaws in the healthcare system. a good beginning toward bringing about meaningful change might be to rethink the priorities currently governing the system.
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