Monday, September 18, 2006

Top Managers Get Big Share of CDC Bonuses

The Atlanta Journal-Constitution and the New York Times both just reported on how the US Centers for Disease Control (CDC) awards bonuses. To summarize the story in quotes from the Times,
Top officials at the Centers for Disease Control and Prevention received premium bonuses in recent years at the expense of scientists and others who perform much of the agency's scientific work, agency records show.

Those inside the office of the centers' director, Dr. Julie L. Gerberding, have benefited the most, the records show.

From 2002 through mid-2006, William H. Gimson III, the agency's chief operating officer, received bonuses totaling $147,863, which included seven cash awards of more than $2,500. Mr. Gimson's bonuses were about twice the amount granted to any other C.D.C. employee, the agency's records show.

Mr. Gimson's deputy, Barbara W. Harris, received six premium bonuses of $2,500 or more from 2002 through mid-2006 for a total of $84,894, agency records show.

Mr. Gimson and Ms. Harris are part of the federal government's Senior Executive Service, a cadre of top civil servants whose salaries are generally among the highest in government.

The increase in bonuses to these officials was part of a decision by the Bush administration to make transformation of the management of the centers a top priority, said Glen Nowak, chief of media relations at the centers. 'If we want to retain people, we need to recognize them,' Mr. Nowak said Friday in an interview. 'We are operating in a highly competitive environment.'

Before Dr. Gerberding's appointment, members of the C.D.C. director's inner circle rarely received premium bonuses of $2,500 or more. After her arrival, in July 2002, such cash awards increased....

In 2005, the records show that officials in Dr. Gerberding's office received 60 premium bonuses totaling $515,075, or about 4 percent of all bonuses granted within the centers.

Because bonus money is limited — about 1.5 percent of the total personnel budget, Mr. Skinner said — the growing share of premium bonuses for Dr. Gerberding's closest advisers has meant less money is available for some scientists and other workers.

The administration also made security a priority, Mr. Nowak said. He said that helped to explain $41,485 in premium bonuses given since 2002 to William T. Porter, the agency's head of security.

Among the other recipients of large cash awards since 2002 were James D. Seligman, the agency's chief information officer, who received $62,455 in premium bonuses; John C. Tibbs, director of the agency's financial management office, who received $52,880; and Kimberly S. Lane, a senior adviser to the Coordinating Center for Infectious Diseases, who received $50,565.
It seems to be the same old health care song - even in organizations where highly trained clinical or scientific staff do the vital work, the hired managers, bureaucrats, and executives always seem to have the financial edge.

Like in stories about how top executives of for-profit health care companies are paid so well, we hear the rationale that the organization must pay managers well to keep top people.

Yet there are reasons to think that the management of the CDC may be troubled. The Times noted,
Soon after arriving at the centers, Dr. Gerberding began a comprehensive reorganization of the agency. In its wake, many of the agency's senior scientists and leaders either left or have announced that they are planning to leave.

The Washington Post and The Atlanta Journal-Constitution have reported on the turmoil at the centers in articles quoting disgruntled former senior scientists who said the changes had undermined the agency.

Five of the six former directors who led the agency in the past 40 years recently wrote a letter to Dr. Gerberding expressing concerns over the exodus of crucial administrative and scientific leaders and scientists, The Journal-Constitution reported.
Furthermore, the Journal-Constitution noted,
Low morale and an exodus of key leaders and scientists from CDC since 2004 has caused significant concern among several of the agency's former directors and drawn the attention of a congressional committee.

The fear is that turmoil within the agency may be harming its ability to handle public health emergencies — from bioterrorism attacks, to an influenza pandemic to the toll of obesity, the Journal-Constitution reported last Sunday.

By the end of this year, all but two of the directors of the CDC's eight primary scientific centers will have left the agency. Other high-profile departures include world experts in several diseases.
The agency's cash awards program is one tool in its arsenal that can be used to improve morale and stem departures. Yet the distribution of frequent large cash awards mainly to budget and administrative staff and managers is an example of how the agency has become increasingly enamored of its non-scientific staff, said three current CDC employees, who declined to speak publicly for this article.

Last year, a CDC poll of its employees, called Pulse Check, found that one of their top concerns was the 'loss of public health focus/mission in exchange for inappropriate business focus.'
Paying larger bonuses to top managers has not clearly correlated with obviously better organizational performance. And why is it so important to pay bonuses to top managers to retain the best employees, while it is not so important to pay bonuses to the scientists, physicians, and other professionals who actually fulfill the organization's mission?

Instead, we hear another familiar song - a once mission-oriented organization has now has "an inappropriate business focus."

If we want health care organizations to provide health care well, if we want academic medicine to do academic medicine well, if we want public health organizations to do public health well, then the organizations must focus on their mission, not on high pay for their hired managers.


InformaticsMD said...

Let me go so far as to challenge the presence in senior management of any organization of people who don't have serious credentials in that domain, regardless of pay. Paying people from the School of Hard Knocks who are making decisions by the "seat of their pants" will not turn a sow's ear into a silken purse.

Anonymous said...

I feel the issue lies in the focus of the individual within the organisation.

A doctor and care workers are focused on the health and well being of the patients and a business manager is concerned with the financial aspects of the interaction.

Seems straight forward as it is, but when the ones controlling the purse strings are the same people who are focused on maximising profit and are not personally generating income, a disconnect with appear.

The exec's don't understand the service delivery aspects of the organisation and will believe they are the sole reason that the wealth is being created, therefore will see that they deserve more.

This is nothing new and will only escalate as western governments try to further emulate the commercial world with the provision of public service.