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Base salaries go up, as do on-call demands at Inter Island Medical Center

Dr. Jan Smulovitz, a retired endocrinologist, asked about the $144,438 on the Inter Island Medical Center’s July profit and loss statement at the Aug. 20 Hospital District Commission meeting.

The answer he received was, for him, disquieting.

“How many physician’s salaries are in that number?” Smulovitz asked during the public comment period.

“Two and a half,” came the reply.

When asked if it was possible for a doctor to have earned a paycheck of more than $40,000, Commission President Lenore Bayuk replied, “It’s conceivable, yeah. We’ve been working on that for some time. This is an issue I’ve been aware of for as long as I’ve been on the board.”

The “that” of which Bayuk spoke are the salaries necessary to staff a clinic that’s being used for round-the-clock care — something it wasn’t designed for, and which comes at a price.

The medical center’s full-time doctors are earning at least $50,000 a year more than in 2001. But Hospital Administrator Beth Williams-Gieger points out that that’s what it costs islanders to have on-call emergency care.

“That’s why you’re paying $1.4 million in property taxes, because if they didn’t they wouldn’t be able to provide 24/7. That’s why they started their whole taxing district situation in 1991 and that’s what they tried to get off the ground on Orcas.

“People over on Orcas are suffering right now. They’re getting flown off for everything. You’ve got to have insurance over there, ’cause no one will come and see you in the middle of the night.”

Gieger broke down the physicians’ salaries into components, something not found on a periodic profit and loss statement:

n Each full-time doctor receives a base salary of $196,000 per year, or $16,354 per month, not including benefits.

As part of each doctor’s base salary, he or she is required to work three days per week in the clinic and one day on-call per week.

n Beyond the base-pay requirements, each doctor is expected to pick up six additional on-call days per month, for which he or she is paid $1,000 per day.

The six on-call shifts per month “is standard in most contracts,” Gieger said. “If you’re a full-time physician, you’re obligated to do so much call, and so much primary care.”

n A third portion of each doctor’s salary comes in the form of a productivity bonus, which is paid quarterly. Included in July’s profit and loss statement were $89,428 in quarterly productivity bonuses paid to doctors Michael Wingren, Greg Moran, Susan Mahoney and Allen Johnson.

n A $10,000 signing bonus was paid to a new physician, Gieger said.

“You gotta pay a signing bonus to get somebody new on board. We’ve had to pay two signing bonuses for two new docs.”

Gieger pointed out that the July payroll numbers, at first glance, are surprising. The medical center was overbudget in doctors’ payroll by $7,438, but under budget for the year by $8,997.

For comparison’s sake, Dr. Burk Gossom said that when he left the medical center in 2001, he was paid “around $150,000,” he said.

Gossom, who now owns and operates San Juan Healthcare Associates in Friday Harbor, feels the extra pay is justified.

“They certainly should have more than the average because of the call and emergency work they do,” he said.

“In the past when I was on staff, all the physicians ever asked for was the national averages. I don’t think that’s enough, frankly. I think they should have more than average because of the call requirements.”

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