April 20, 2014
To the Editor: Laredo Morning Times
From: Dr. Luis M. Benavides
Re: Response to CMS's Data Dump
Your timing of the sensationalist report about physician earnings on a Holy Day Morning is only matched by the lack of comprehensive reporting.
Although I do not challenge the numbers reporting, I believe that there is significantly more data that could help the taxpayers understand the numbers much better.
Let’s start with the fact that what the numbers represent is gross payment, not “take home” pay. Even the most efficient office has a 50-60% overhead expense. Most of that expense is for employee salaries and benefits. If you take into account all the money we (all the Doctors in Laredo) are re-investing in our community in the form of our staff salaries, the public would understand better the service we provide. In addition, some of us have invested in technologies that assist our patients greatly and save them and their payor source (Medicare and otherwise) a significant amount of money.
Another issue not discussed has to do with the fact that we are still in a healthcare shortage area. This skews the numbers because of the many patients we see, not to make more money but to simply take care of our large population with complex problems.
In addition, you do not take into account the amount of training we have gone through, the mountains of paperwork we need to do and the time away we sacrifice from our families to be with our patients, including holidays and weekends.
As examples, I would like to use the physicians you targeted to illustrate.
Your front page target was Dr. Ricardo Cigarroa. This is a well respected hard working physician of our community. He has chosen to return to his hometown, to invest a large amount of money in a state of the art medical facility that cares for his cardiology patients. If I extrapolate from my 10 employee office where I spent over $350,000 on salaries and benefits and you take into consideration that he needs employees with certain technical expertise, he is likely paying out a large sum, perhaps close to $2,000,000 in salaries alone. And that does not include the overhead for his office, the equipment he invested in, insurance, and all the other expenses every businessman small or large has to pay. Add to that the fact that he is at the hospital quite a bit (I sometimes make rounds in the morning and I see him there and I sometimes make rounds in the evening and I see him there) and the fact that he is responds to my calls when I have an emergency and promptly sees my patient (as do almost all physicians) and you could appreciate the amount of time he devotes to his patients.
Another mention was of Dr. Benson Huang, also a hard working, well respected physician, who works tirelessly with critical patients and at times not even appreciated by the health care institution he does it most for (he had a difficult time with some Medical Staff issues and the WZJH CMS stood firmly behind him). Again he works long hours in serving his patients and bringing them back to health.
Dr. Eduardo Miranda, previous maligned by your newspaper, provides oncology services and has large overhead to provide appropriate medications for his patients. He has never refused to see my patients regardless of ability to pay. And when he used a very useful medication and by simple human error ordered it from the wrong place, a location within the US, he is placed under scrutiny and made to look like a criminal. (As an example, when my Mother needed medication that was not made in the US but was safe to use in Europe and Mexico, I went across and bought it for her; had I prescribed the same for any of my patients and definitely had I brought some and given it to a patient, I too would have been labeled as committing a crime).
The list could go on but your policy limits the length of my letter.
I ask anyone who read this article to keep an open mind, to read between the lines, and to look for what “the rest of the story” is.
Luis M. Benavides, M.D. F.A.A.F.P.
Webb-Zapata-Jim Hogg County Medical Society