Dear Director: My hospital CEO told me to make sure my group is donating to the hospital foundation this year. Don’t I give enough to the hospital every time I take care of an uninsured patient? Why should I be doing this?
My first year as a chairman, I made a nice gift to the hospital foundation. I was pretty pleased when my CEO brought it up during our regular meeting . . . until he told me I should have given more. Sure, he thanked me for my contribution, but then he told me I should have given at least as much as the other chairman in the hospital. I was shocked, and frankly a little confused about what to do.
Why give to charity
Most Americans give something to charity each year. Text-to-give campaigns have made it so idiot proof to donate money after a natural disaster that it’s hard to find an excuse not to give. The median amount given annually is about 4.5% of one’s income, but that percentage tends to drop at the higher ends of the pay spectrum. It wouldn’t surprise me if the doc who makes $250K a year only gives $5000 – or 2%. Whether you’re just after the good feelings associated with giving or you are passionate about causes in your life there are a hundred reasons to give, and a thousand ways to do it. For my wife and me, our major contributions go towards things we feel strongly about—education, our dogs (SPCA), her church, and my hospital. We make smaller donations to support friends raising money for various other causes. We feel fortunate to be able to have causes we believe in and to be able to give.
Of course, there’s also a decidedly less personal side to charitable donations. From a business point of view, making an appropriate donation as a group may enhance your image (and therefore job security) with the C-suite. I’ve seen several groups around the country have amazing contract stability despite only adequate performance after the group made a seven figure contribution to the hospital. Sometimes, individual gifts will also get you invited to VIP foundation receptions, which can be good for your career as you spend time talking to your hospital CEO or board members in a relaxed, feel good environment. After all, professional success includes maintaining relationships.
The Hospital Foundation
The purpose of the hospital foundation is to raise money on behalf of the hospital as well as receive and manage the money that comes in. Healthcare is a tough business. We feel it every day, particularly if you have a 40% collection rate or a 20% self pay rate. I know as emergency physicians we feel like we’re “giving” a lot to the hospital and the patients already. While the money raised by the hospital foundation may go towards the general operations, more likely this money is used on capital improvements that may include specific programs, facility upgrades, or the development of service lines. Hospital profits generally aren’t sufficient to fund large capital projects. To complete these, the hospital needs to use earnings off of their investments and also have a foundation that can raise money in large (and small) increments. Because people often give money when they’re moved by a story, it shouldn’t surprise you that your hospital’s magazines frequently focus their stories on patient’s lives that doctors have saved. These stories make people want to give and allow for your community to invest in the hospital. If your foundation is raising money for a new cath lab or oncology suite, donors get a tangible connection to something they, or their family member, may need in the future.
There are several reasons it’s important for doctors to invest in their hospital. First off, from a leadership perspective, the community feels reassured that it’s a good investment when the physicians are also investing. When docs invest, the community feels that the docs believe the hospital and foundation have competent leaders. When the foundation is looking to raise $5 million to $50 million for a new ED or campus expansion, don’t you think it’s easier to convince a big donor to invest in the hospital when 100% of the ED staff invests in it already?
How much to give
A colleague of mine told me that everyone is “encouraged” to give at his site. At this site the target gift is 1% of your annual salary starting three years after residency. As chairman, he gives more. That’s probably more than most people contribute, and honestly more than I do. Then again, sometimes it less about total dollars, and more about buy-in. Fundraisers will tell you that one of the main ways they use physician gifts is to tell major donors how much physician buy-in there is. They like to be able to say that 50, 60, or even 90% of their physicians feel the cause is important enough that they invest their personal dollars in it. Your gift can be as little as $25 but it increases the percentage of physicians who give, and that adds value. Your alma mater does the same thing. It’s easier for them to get large donations when they have a high rate of alumni giving. Most hospitals allow you to earmark your donations for a specific department, so when my ED needs a new ultrasound or high tech piece of airway equipment, the money that we’ve invested in the department should be there to guarantee that we have the equipment we need to care for our patients.
How much you give is obviously a personal decision based on your overall financial picture. My wife and I have a general understanding of what charities we give to and what our annual giving budget is. But I try to be generally in line with the other chairman at my hospital. Some years I’ve also played in the hospital golf tournament which increases my contribution. Many ED physician groups will also make contributions to the foundation or sponsor events. These group donations are important, but they don’t take the place of personal contributions.
Conclusions
While I don’t know what percentage of my group gives to our hospital foundation, I do believe it’s important to be a part of the hospital community. As leaders in this community, I encourage you to give to your hospital foundation. You’ll make a difference in patient care, feel good about yourself, and will be appreciated by your employer. Even if you start small, you’ll increase total buy-in and help your hospital raise money from bigger donors.
Michael Silverman, MD is a partner at Emergency Medicine Associates and is chairman of emergency medicine at the Virginia Hospital Center.
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9 Comments
Our hospital, in lieu of it’s usual Christmas gift, made a donation to the Hospital Foundation (they didn’t tell us in what amount) in our name.
Frankly, I disagree in many ways with the author’s conclusion. I think we contribute in many other ways that are as or more signficant than a monetary donation. If the community can’t see our commitment via our practice, the certainly will not see it in a cash donation–which most will likely never know happened.
Outstanding discussion of “Physician-donations,” meaningful to me as I was the designated collector for my Department for our Campaign – I got 100% participation several years in a row! Please feel free to publish this note. With humility! With respect! With apologies for my meager writing. With Best Holiday Wishes…
let the contract management companies that profit from our earnings donate. my hospital pays nurses $40/hour to do call backs to make surveys better, 20k for blanket warmers to make surveys better. they pay a customer service rep to go around giving sandwiches to our no pay patients that i have to see for free. i am not giving a dime of my hard earned money to them.
I am more predisposed to donate to situations and institutions which focus on actually helping people. Not emphasizing the laughable goal of higher metric results such as Press Ganey Scores. When this stupid thought process stops I will be more positively inclined towards them.
Donating to a special cause is an individual decision. When the Chair of the Dept pushes for his peons to donate, its for ulterior motives that are clearly for the chairman’s best interest. While the contract management groups fleece and exploit the ED physicians, the chairman has to kow tow to his employer. Once the corruption ceases, I’ll donate.
Conclusions (REVISED FOR REALITY)
While I don’t know what percentage of my group gives to our hospital foundation (i dont believe this for a moment, I’m sure that as a “Leader” you are given reports on who is giving), I do believe it’s important to be a part of the hospital community. As leaders (this word has been turned into a joke and is mandated to be mentioned at least 3 times in any ridiculous self proclaimed alleged leaders communication) in this community, I encourage you to give to your hospital foundation. You’ll make a difference in patient care (how about making a difference by seeing patients ), feel good about yourself (?), and will be appreciated by your employer (when did physicians start caring about what their employers thought ov them? I thought we were here to take care ov the sick as best we could). Even if you start small, you’ll increase total buy-in (please avoid any of these cult like group mentality mba terms if you want to be taken seriously) and help your hospital raise money from bigger donors (that will land in the pockets ov the leaders).
I’ve donated to our hospital’s foundation for many years. Then, after seeing the funds go toward “public relations” via executive golf trips to The Masters’ golf tournament (families included – plus, not just tickets to the event but also a few rounds of golf at nearby golf courses), I decided to end my contributions to this charade. If I’m not providing enough value to our hospital’s mission by providing EM care 24/7/365 then they can find another doc to work those hours many, if not all, of the “E-suite” suits would find unthinkable. The MBA’s have done a great job at lobbying against the physician professionals as being “over-paid, over-compensated” necessary evils to the delivery of healthcare. Only to turn around and pad their own jobs in a manner that defines the term “hypocrite”. For now, I’ll be keeping every last nickel and finding more authentic avenues to donate the fruits of 12 years of medical education (undergrad / med school / residency). Heck, I may even go out and play a round of golf at my own expense! FORE!
I’m sure the author of this article has gotten more than a few laughs reading through this string of replies. I guess he can sleep at night with a clear consciousness as he joins his comrades in medicine….or is that business?….and trolls his way through another exciting meeting at 2pm on a Tuesday afternoon. Let’s hope that the suits don’t overlook the names listed on the year-end donor report: “Platinum”, “Gold”, and “Silver” monetary categorical designations. Perhaps even the “Society” level for those who have made the ultimate sacrifice of giving more than many people make in a month. There has to be a nice admin job awaiting one lucky donor’s sweat & tears?!?
Time to hit my fairway shot……I think I may play an extra 9 holes today.
I don’t understand how hospitals and physicians groups can ask for donations from patients when they routinely provide discounts to the insurance companies. Insurance typically pays only 10 to 15% of the total billed. The patient pays a token amount and the rest is written off. If insurance companies paid the full amounts there wouldn’t be a need to ask for donations. Of course, the poor schmoe with no insurance is billed the whole amount–no discount allowed!
Ascensions ceo made 17mil and the company had 20b in profits. In the same year they only gave free care or community benefit services totaling 3%. At least 5 other managers make over 3mil per year. I’ll never give them a dime.