• Most organizations (82.3%) reported that all of their medical directors have contracts. Of those contracts, the majority, (72.9%) are for just one year — the fourth year in a row that number has increased.

• Wages are 3.9% higher on average for independently contracted medical directors to account for foregone taxes, benefits and insurance payments.

• The number of organizations offering performance bonuses to medical directors was up 4.3percentage points from 2010, to 26.9%.

Median hourly rates increased by an average 3.0% from 2010 to 2011.

The data is intended to help health care organizations make compensation decisions and learn more about current market trends. For more detail, visit IHS’ survey page.

Reporters at the Los Angeles Times found a number of public hospital execs making serious bank — more than $1M in one case.

The hospitals and their CEOs  say the salaries (and related bonuses and perks) are fair — and in fact, relatively modest compared to what their private-hospital peers make. The hospitals claim paying significantly less would hurt their ability to recruit the best talent.

But after public scandals like that discovery that the town administrators in tiny Bell, CA, were making astronomical amounts for what were essentially part-time gigs, many taxpayers feel that million-dollar salaries for public employees are a luxury the state can’t afford.

The recent Wall Street Journal CEO Compensation Study found that health care CEOs had the highest median pay of any industry, coming in at $10 million per year. The study took into account all direct compensation: salary, bonuses and the value of stock and stock options at the time of the grant.

The study looked at CEO compensation at 456 U.S. companies with revenues of  $4 billion or more as of their most recent fiscal year.

According to the Hay Group’s 2010 Healthcare Compensation report, the number of hospital CEOs who got a raise of 6% or more was down to 22% last year — the lowest level in the past 10 years.

But C-level execs aren’t headed for the hills — turnover rates were down last year.

Pros: Better patient care overall. Cons: Docs working longer hours to make the same income.

That’s the result of recent research published in the Archives of Internal Medicine.

The research team collected retrospective data on more than 46,000 visits to primary care doctors by adult patients, between 1997 and 2005. The study showed that the number of visits increased 10% over that period and the average length of a visit increased 16%, from 18 minutes per patient to almost 21 minutes.

Some types of visits increased in duration more than others:

• regular check-ups increased by 3.4 minutes
• high blood pressure checks increased 3.7 minutes
• diabetes diagnoses increased 4.2 minutes, and
• joint disease diagnoses increased 5.9 minutes.

Part of the reason for longer visits is that patients are learning to be more involved in the health care decision-making process, so they come to appointments armed with questions about tests, medications they’ve seen advertised and that tip Aunt Hilda passed on about how eating raw garlic can ward off arthritis.

While few would argue against patients being more engaged in their own care, dealing with those questions does take up valuable clinical time — and like it or not, doctors don’t get paid for their bedside manner. The end result is longer hours for doctors, while total compensation stays the same — if they’re lucky.

What can help

Some practices are instituting smart strategies to free up doctors’ time while still giving patients the time and attention they need and want.

Those strategies include having other staff on hand (physician’s assistant, nurse practitioners, etc.) to handle routine care, as well as group visits, where patients with similar conditions can meet with clinicians to discuss outpatient care and self-management.

In the case, the feds claimed Covenant Medical Center of Waterloo paid five doctors for referring patients to the hospital for services. Some of the physicians were making more then $2 million a year — roughly double the expected compensation for their positions.

The feds claimed that the docs in question were paid far more than market value, which disqualified them from receiving Medicare funds and that the payments violated the Stark Law.

Covenant denies any wrong doing, claiming that the doctors were specialists working in understaffed specialties.