National Press Club

Reduce health care costs by putting docs on salary, says Cleveland Clinic executive

July 20, 2012 | By Robert Webb | rewebb@aol.com

Cleveland Clinic chief executive Dr. Delos "Toby" Cosgrove addresses health care policy at a July 20 National Press Club luncheon. Club President Theresa Werner and former Secretary of Defense William Cohen joined him at the head table.

Cleveland Clinic chief executive Dr. Delos "Toby" Cosgrove addresses health care policy at a July 20 National Press Club luncheon. Club President Theresa Werner and former Secretary of Defense William Cohen joined him at the head table.

Photo/Image: Noel St. John

U.S. hospitals must find new ways to halt the nation's soaring health care costs, Dr. Delos Cosgrove, president and chief executive of the Cleveland Clinic, said at a July 20 National Press Club luncheon.

One step they should take is to put all doctors on salary, as the Cleveland and Mayo Clinics do, according to Cosgrove.

Most doctors charge patients based on tests and other services they perform.

"Doctors on salary are paid the same no matter the number of tests and other services," Cosgrove said.

He also came down hard and repeatedly on the "obesity epidemic," chronic smoking and the poor exercise habits of the American people. Reducing obesity and smoking and increasing exercise would cut health-care costs, Cosgrove said.

"We don't allow smoking on Cleveland Clinic property," he said. "And we've stopped hiring smokers."

The Clinic's smoking cessation efforts have reduced from 28 percent to 15 percent the number of smokers in the county surrounding Cleveland.

Cosgrove, who received his medical degree from the University of Virginia School of Medicine, joined the Cleveland Clinic in 1975 and became chairman of the Department of Thoracic and Cardiovascular in 1989. A renowned cardiologist, Cosgrove said he had done 22,000 operations.

Founded in 1921 by four Cleveland physicians, the clinic ranks among the nation's top hospitals in the annual ratings by U.S. News and World Report magazine.

Cosgrove did not speculate on how the Cleveland Clinic may be affected by the recent Supreme Court ruling that the nation's health care reform law is constitutional. But he emphasized the Affordable Care Act is designed to bring medical care to millions who have no health insurance.

He stressed the role technology plays in helping patients manage their own care. For instance, medical records at the clinic are now sent quickly to patients anywhere in the world.

Cosgrove also noted a change in titles at the clinic.

"We are no longer doctors or nurses but are called care-givers," he said.

Cosgrove outlined Cleveland Clinic's international expansion goals. Although it failed to acquire a hospital in England, it is building one in Abu Dhabi.

The clinic's roster of global patients includes the royal families of Nepal and Bhutan and the deputy prime minister and interior minister of Saudi Arabia.

Cosgrove introduced one of the clinic's international patients who was in the ballroom audience, a young international opera soprano, Charity Sunshine Tillemann-Dick.

"She was at the Cleveland Clinic for a double lung transplant so she could sing again," Cosgrove said. She did resume her career but complications forced her to have another double-lung transplant in March.