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USF docs are highest-paid public workers

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By BAIRD HELGESON

bhelgeson@tampatrib.com

Published: June 21, 2009

TAMPA - Everybody knows the boss is the highest-paid person at the University of South Florida, right?

Not even close.

Neil Fenske, the director of the USF medical school's dermatology department, was by far the university's biggest breadwinner last year, taking in $1.49 million. USF President Judy Genshaft made $395,000, according to a government salaries database compiled by The Tampa Tribune.

Fenske and other USF doctors are the highest-paid government employees in the Tampa Bay area, a topic of special public interest as governments struggle to operate on less money during the recession.

In fact, of the top 50 highest-paid government workers in the Bay area, 46 work at USF Health, which includes the colleges of medicine, public health and nursing.

Tampa Mayor Pam Iorio's salary of $149,999 didn't even crack the top 600.

Doctors have a different pay structure than most public employees. Mayors, state officials and university presidents are paid entirely from taxpayer money. But public dollars generally make up only a small portion of doctors' salaries.

A good chunk of their income comes from research and practicing medicine, which helps bankroll the medical school.

Medical school salaries are close to what a doctor would make in the private sector, said Michael Hoad, a USF College of Medicine spokesman.

"We try to make it less, but not too much less that they wouldn't want to do it," he said.

Consider Fenske, who is chairman of the dermatology department. He made $1.28 million seeing patients last year, according to the USF medical school.

Fenske writes a column for the Tribune and appears on the air with its television partner, News Channel 8.

TGH is teaching site

Medical school faculty members are not allowed to have private practices. The USF Physicians Group, the college's group practice, includes 429 physicians and 69 nurse practitioners who see patients throughout the Tampa Bay area.

The doctors work through nonprofit companies created to aid the medical college. The University of South Florida Medical Services Support Corp. is among the largest.

The $49.7 million-a-year organization handles all the billing and collections for doctors' fees. The USF medical school does the bulk of its teaching at Tampa General Hospital, where its faculty and students see 60 percent of the patients.

A USF medical school doctor's salary and duties are broken down into three main components: seeing patients, teaching and research.

Some doctors could spend slightly more time seeing patients, while others might focus a little more on research or teaching.

The department chairperson sets each doctor's base salary and rank in the department to ensure pay is consistent. The doctor negotiates salary, along with obligations for time spent teaching, doing research and seeing patients.

Department chairmen have a menu of options to piece together a doctor's salary, including revenue from patient care, tax money and research grants. Taxpayer contributions generally top out at $200,000 per employee.

Fenske, for instance, got $145,000 in base pay from tax money.

Department heads and the dean generally make less money practicing medicine but get stipends for their extra administrative duties.

Stephen Klasko gets a $150,000 stipend for his work as dean of the medical school. Last year, he made $373,790 practicing medicine.

Perhaps no factor is more important in determining salary than medical specialty.

Surgeons and specialists such as radiologists, dermatologists and cardiologists earn more than primary care physicians like family practice and obstetrics and gynecology doctors.

Kira Zwygart, for instance, makes $125,288 as a family health physician and assistant professor at the medical school. The median salary for that job in the private sector is $135,327, according to Payscale Inc., which compiles salary data.

Among all medical schools, USF generally falls in the middle in terms of compensation, said Hoad, the College of Medicine spokesman.

Doctors generally take home about half of the money they make seeing patients, Hoad said. The other half goes to pay the cost of overhead, administration and for the medical school itself.

David J. Smith Jr., chairman of the surgery department, made $759,000 seeing patients, which means he billed for about $1.51 million. That's comparable to the private sector, in which doctors must pay overhead and staffing costs, Hoad said.

Avoiding conflicts

Medical schools haven't always been set up this way.

Years ago, medical schools hired physicians to teach. The doctors had private medical practices and taught on the side. But the system created the potential for a conflict of interest as some doctors benefited financially from their research and ties to the school, Hoad said.

In 1996, a jury acquitted John Najarian of the University of Minnesota of federal fraud and embezzlement charges relating to a transplant drug, ALG, he helped create. Prosecutors alleged he made millions prescribing a drug not approved by the U.S. Food and Drug Administration.

Najarian, a pioneering transplant surgeon, said the system often lacked balance.

"A few of the doctors were very enterprising and lived a very high life," Najarian said last week. "At the time, what you made, you kept. They didn't give much back to the school."

Others did not have vibrant practices, he said. "They spent more time teaching, and basically did no research."

Medical schools across the country have implemented tougher conflict-of-interest policies. More than ever, the salaries better reflect the work being done, experts said.

"The salary structure reflects our mission," Hoad said. "We want to make sure the money we get for research goes to support research, and the money we get for education goes to education."

Reporter Baird Helgeson can be reached at (813) 259-7668.

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