County OKs Pay Hike for Doctors

Los Angeles County has agreed to nearly double the pay of doctors who moonlight at County-USC Medical Center, averting a threatened shutdown Monday of emergency services at General Hospital and Women’s Hospital.

The chief of emergency medicine, Dr. Gail V. Anderson, and the chief of obstetrics and gynecology, Dr. Daniel R. Mishell Jr., last month told county health officials that they would close the walk-in emergency services July 1 if they were not given money to pay more attractive wages to moonlighting doctors, who augment the full-time medical staff during busy periods and on nights, weekends and holidays.

Anderson and Mishell, in letters to hospital administrators, both asserted that the $35 an hour paid to these doctors could not compete with what nearby private hospitals pay moonlighting doctors. As a result, County-USC’s emergency services were running shorthanded, a situation the doctors said might lead them to order their closure.

The county Department of Health Services has agreed to increase the hourly pay rate to $65, according to Harvey Kern, spokesman for County-USC. Mishell said through his secretary that the pay increase has solved the problem.

County officials were unable to say how much the pay boost would cost. About $2.5 million was spent last fiscal year for moonlighting doctors in the two emergency rooms.

The walk-in emergency rooms at Women’s Hospital and General Hospital--two of four hospitals at the medical center--handled 158,000 patient visits last year, according to hospital officials. They are separate from emergency trauma services that handle seriously ill or injured patients, or those brought in by ambulance.

The doctors’ letters were sent amid discussions between the county Department of Health Services and USC over which was responsible for providing additional money for moonlighters.

County-USC is the main teaching hospital of the university’s medical school. Faculty doctors and resident physicians make up the bulk of medical staff. The county health department pays USC a lump sum for these doctors’ services, but the moonlighters are paid separately by the county according to a rate set by ordinance.

Carl A. Williams, the health department’s assistant director for hospitals, contended that the physician-service contract with USC, signed 3 1/2 years ago, called for the university to eventually phase out reliance upon moonlighting doctors.

But USC disputes this. Dr. Joseph P. Van Der Meulen, vice president for health affairs, said the contract is silent on the issue of moonlighters.

Williams also said that to raise the hourly rate for moonlighters at County-USC would require action by the county Board of Supervisors, a slow process, and one that might result in setting a precedent for pay increases countywide.

Williams said the moonlighters were given the extra money through a mechanism that allows wage increases to “individuals in specific settings or situations” without affecting pay rates elsewhere in the county system.

Van Der Meulen said the university is happy to have the immediate crisis resolved, but remains concerned about what he termed inadequate staffing levels in the busy emergency rooms. Anderson said he was unclear whether the pay boost for moonlighters would adequately address the staffing issue.