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Health Law Blog

Hospitals Pay Hundreds of Thousands of Dollars to Consultants, Public Auditor Finds

November 24, 2010

Recent reports of our public hospitals paying consultants hundreds of thousands of dollars in fees is not simply disturbing from the point of view of the appropriate use of the public health care dollars. It is particularly disturbing in view of the fact that many hospitals ask our medical leaders to undertake onerous, stressful, 24/7 positions as Chiefs of various departments (including emergency departments) in return for compensation that can only be described as insulting. The ongoing justification for the low remuneration offered by many hospitals is the purported lack of funds.

In some busy community hospitals the belief seems to be that Chiefs of Emergency Departments should occupy the position for salary stipends prorated to two days per week. This completely overlooks the fiduciary duty that goes with such a job. For example, Chiefs of Emergency Departments are expected to cover for staff, by taking calls for those who cannot do so as a result of sickness or unexpected absence. The fact that the Chief may have already worked 60 or 70 hours that week is immaterial. Similarly, if the Department is overcrowded or is not processing patients appropriately in the middle of the night, the Chief is expected to go in. The administrators and the consultants are all entitled to go home.

It’s time the Chiefs of our hospitals worked together as a team; this should involve mandatory disclosure by each hospital of what is spent on consultants and what those consulting fees cover. This disclosure should be a prerequisite for Chiefs accepting remuneration for their leadership, supervision and the onerous responsibility of delivering timely accessible patient care.

Testimonials

Several years ago I was fortunate enough to have been selected as a Tremayne-Lloyd Fellow here at Western Law. I used the funds to finish a book and to begin work on a new one. It dawned on me far too late that I had never thanked you for that splendid gift. The new book is to be published by Harvard Press in 2010. The TTL Fellowships provided ritual seed capital for this project, which required me to spend a good deal of time and money at The National Archive in Washington. Again, with many thanks.

R. W. Kostal Professor of Law and History

Tracey Tremayne-Lloyd Health Law