Pay cut prescribed
for Straub doctors

The reductions will range from 10
to 30 percent due to reduced payments

By Helen Altonn
Star-Bulletin

Doctors at Straub Hospital & Clinic are planning to take pay cuts ranging from 10 to 30 percent next month because of reduced federal, state and private insurance payments for medical services.

"All of the medical institutions in the state had a challenging, difficult first quarter," said Dr. George McPheeters, secretary of the board for Straub's physicians' corporation.

He said the hospital is very busy and the number of patients is higher than it ever has been but "we're having more payers reimbursing at a lower rate."

McPheeters said details haven't been ironed out but the physicians' board has discussed a range of pay cuts "depending on a variety of criteria. It is not going to be across the board."

He pointed out that the hospital's Tennessee-based management company, PhyCor Inc., has nothing to do with physician salaries.

But PhyCor also is making some changes to cut costs, including closing two of Straub's 11 Oahu clinics and laying off 40 employees.

PhyCor gets a share of Straub's profits under its management contract, but "there hasn't been a lot of that lately" with reduced reimbursements, said heart surgeon Mark Grattan.

"Medicare is hammering hospitals," he said.

Some Straub workers are seeking representation by the International Longshore & Warehousemen's Union, citing job security, morale and patient-care issues.

McPheeters said the doctors are "out of that loop. That is a PhyCor issue. It is not being discussed (by physicians). We sit around and talk about the best way to take care of our patients."

McPheeters and Grattan strongly contradicted statements by Shirley La'a, a nurse's aide and 10-year Straub employee, that patient care is slipping because of old equipment and inadequate supplies.

"It makes my blood boil," McPheeters said. "Nothing could be further from the truth. Doctors would not sit still for a situation that would put patients at any sort of risk. The care patients receive at this hospital is exemplary."

Grattan said he and McPhee-ters, a general surgeon, both operate at The Queen's Medical Center, as well as Straub, "and I think that patient care at both hospitals is outstanding, and I wouldn't tolerate for a minute anything else."

Grattan said PhyCor put more than $10 million worth of capital improvements into Straub just in the last year.

"And frankly, that's part of the reason doctors need to take a pay cut," he said. "We've done that ourselves so we can assure there is continued equipment that will be cutting edge for the patients."

McPheeters said the entire sixth floor of the hospital recently was closed for new bathrooms, flooring, lighting and a sprinkler system. Other floors also are being renovated one by one, he said.

He said PhyCor installed a new cart system for supplies.

"Everything you could possibly need is right there -- much of it in higher quality than we used to get."

PhyCor also bought the latest and best smoke evacuators, surgery and neurosurgery equipment for every operating room, McPheeters said.

An ultrasound machine worth $40,000 to $50,000 was purchased for his practice, he said. The best laparoscopy and video equipment available also were recently acquired for the hospital, he said.

Any claims of deteriorating patient care are "ridiculous," McPheeters said.

"Our cardiologists are some of the best in the community. They're ethical almost to a fault. They would not sit still for shoddy care."

Grattan, who had knee surgery recently at Straub, agreed: "I wouldn't stand for a minute for suboptimal care. I would take all my patients to Queen's."

McPheeters said PhyCor was slow to change management, but both he and Grattan commend the new leadership under John Grimes, chief executive officer.

"It has been a tremendous improvement," Grattan said.

He noted Straub and Queen's have been discussing possible consolidation or merger of some services to cope with the reimbursement dilemma.

"In that setting, and particularly locally where there is a tremendous oversupply of physicians and hospital beds," Grattan said, "with clear-headed thinking of PhyCor leadership under John Grimes and the board at Queen's, we have an opportunity here."