Why do hospitals to pay a salary to some medical specialists but not to others?

Question

Why does the United States government allow hospitals to pay a salary to some medical specialists (i.e. anesthesiologist, pathologist), but not to others (.ie. general surgeon, pediatrician)?

Answer 1

The "government" allows businesses to run themselves.  

That general surgeon and pediatrician you're referring to, they are NOT employees!  So obviously, you don't pay a salary to someone who isn't an employee.  They just have "operating priveleges" at the hospital.

This is done, to keep medical costs down.  MOST of the doctors that work out of a hospital are NOT employed by the hospital.  Because the hospital lets them use their equipment and operating rooms, the doctors then avoid having to buy their OWN equipment, and maintain sterility in their OWN operating rooms.

Answer 2

Have you ever been to the hospital for treatment and received multiple invoices/bills for services rendered?  Some hospitals are run by HMO's (Health Maintenance Organizations), and others are organized under a PPO (Preferred Provider Organization) system.  

The HMO's hire doctors directly to work for them, and are paid a salary.  HMO's treat individuals with the idea of early detection through managed care, routine exams, etc.

PPO's, one of the most popular arrangements for major medical insurance coverage, has arrangements with independent doctors and groups that has a pre-determined fee for services.  UCR (Usual Customary, and Reasonable) is the term used to describe the "average" cost/charge for any given medical service.  Networks of independent doctors and practices help keep prices stable, and discounts can be passed-on to the end-user (you and I) because practicioners do not have a huge marketing budget and other overhead.  Think of doctors in this system, for the most part, as a bunch of independent contractors.