Working side-by-side with surgeons, operating room professionals are key to a smooth-running, money-making surgical department. Naturally, these highly-skilled workers command high-ranking salaries. Adding to an already overloaded schedule, recent administrative changes have further increased the workload for O.R. and Surgical Services employees. They’ve been inundated with additional paperwork, government mandates, and other increased demands yet continue to deal with a nationwide nursing shortage.

According to Doris Ruiter, R.N., MS, director of surgical services, Lakeview Medical Center, Rice Lake, WI, changes such as implementing new JCAHO Patient Safety Goals, (including mandatory time-outs and labeling of medications on the back table) while important, have placed additional stress on an already thinly spread workforce. "We are facing enormous amounts of change from federal and state agencies," said Ruiter. "These changes we can see as great improvements over patient safety, but they still reflect change, which can be difficult, and take time. We need time to plan an individualized plan of care and then be allowed to implement that care. In addition, reimbursement issues are also of concern. [We’re] always trying to do more with less," she said.

Purchasing power

O.R. personnel have also been charged with increasing purchasing responsibilities in recent years. When questioned about their purchase power in the facility, nearly 90 percent of the respondents to the Healthcare Purchasing News 2005 O.R. Salary Survey said that they recommend and/or specify products to be purchased for the O.R. Another 81 percent said they evaluate products, 80 percent determine the need for such products and nearly 60 percent are members of a purchasing group or committee. A mere 3.6 percent said they were not involved in any way in the hospital’s purchasing decisions.

"I have seen a tremendous movement into the business world from the clinical aspect," said Ruiter, who holds a Masters degree in Health Care Administration. "I feel that my clinical background has been essential for what I am dealing with now in relation to contracts and purchasing needs." Ruiter said her department formed the facility’s first value analysis team in surgery, which has now become a model for the entire hospital.

To account for this new role in purchasing within the O.R., we added a new choice of job functions to our 2005 survey – "O.R. Materials Manager". The 21 percent of our survey respondents who claimed the title of O.R. Materials Manager earned an average salary of $44,688, the lowest earners of all O.R. titles from our survey. Adding this job function has lowered our overall average salary across all titles to $67,968 for 2005, about a 4.5 percent decrease from last year’s average salary of $70,880. In order to compare more accurately to our 2004 findings, when we remove O.R. Materials Managers, the remaining titles produce an average salary of $74,368, nearly 5 percent higher than last year’s average.

Highest earners by title for 2005 were O.R. Directors/Managers at $77,073 – and they made up the majority of our respondents at 37 percent. Twenty-five percent were Surgical Services Directors/Managers, and they made on average $75,893. Almost 30 percent of our survey respondents made $80,000 or more; nine percent earned $100,000 or more in 2005.

For those who are making the buying decisions for their O.R.s, the top product areas they purchase/specify for are: O.R. supplies/equipment (96%), drapes (90%), gloves (88%), custom procedure trays (82%), endoscopic products (82%), orthopedics (79%), disposable kits and trays (77%), safety eyewear (73%), dressings, lighting systems, patient warming equipment and protective wear (all at 71%).

When asked what they would like to see more coverage of in Healthcare Purchasing News, top answers included: O.R. equipment, O.R. suites, inventory control, surgical instruments, surgical instrument tracking, infection control and minimally invasive surgery.

Experience, age and education

Average Salary by Education

When it comes to years of experience in the industry, highest earners are still those who have worked between 20 and 24 years in the O.R. at an average of $74,138. Those just entering the profession with only 2 to 5 years of experience were the next highest earners at $64,444. Lowest earners by years of O.R. experience were those who had been working between 5 and 9 years in the O.R. at $54,615. Conversely, those who were new to their facility, with less than two years on their current job, earned the highest salaries, at $77,500. Our survey respondents have an average of 17 years of experience in the O.R. and have worked 11 years at their current facility.

As with most any profession, higher degrees of education bring higher salaries to O.R. staff. 36 percent of our respondents have earned a bachelor’s degree, down from 43 percent in 2004, and they make on average $73,625. Another 30 percent reported an associate’s degree as their highest level of education, up 9 percentage points over 2004. They earned on average $57,727. Those with a post-graduate degree, totaling 20 percent of our respondents, earned on average $85,543.

Reversing recent trends, the average age of our respondents dropped from 51 in 2004 to 48 this year, perhaps also contributing to lower average salaries. Ten percent less respondents were over the age of 40 this year, accounting for 81 percent of the total. There was also a 6 percent reduction in the number between the ages of 61 and 65, and a 7.5 percent increase in the number of respondents between the ages of 36 and 40.

The number of females working in the O.R. profession continues to far outnumber males. This year our survey showed an even greater number of females, at more than 81 percent. The majority of female O.R. workers continue to make more than their male counterparts earning $69,438 compared to $57,976 for the men in their profession.

Facility stats

When comparing salaries nationwide, highest earners still work in the Pacific region, pulling in an average of $95,313. Second-highest earners are also still found in the Central region, earning an average salary of $67,778. The Southeast remains the lowest earning region at $63,026.

Average Salary by Region

Most (45 percent) of our respondents work in rural areas, yet they were paid the lowest salaries, at $62,745. Highest earners work in urban facilities, earning on average $75,667.

Average Salary by Type of Hospital

Ten percent fewer work in a standalone hospital compared to 2004, though they still make up the majority of our respondents at 71 percent. At the same time, 10 percent more reported working for an Integrated Delivery Network (IDN)/Multi-group practice for a total of 22 percent. Similar to last year, just under 6 percent work in a surgi-center/ambulatory center. In addition, 77 percent of our survey respondents work for a non-profit facility, similar to last year.

A very small percentage work in government-owned facilities, but they earn far higher salaries than those working in non-profit or for-profit facilities at $99,500. For profit hospitals paid their O.R. staff an average salary of $69,762 according to our 2005 survey.

The size of the O.R. worker’s facility also contributes to salary differences. Top earners could be found in those facilities with over 1,000 beds at $92,500. Those working in facilities with between 500-749 beds earned $84,375. The average number of beds reported was 226, and facilities with between 200 and 299 beds paid their O.R. staff an average of $59,773.

Average Salary by Number of Beds

The number of O.R. suites in a facility also plays a role in salary size. The average number of O.R. suites reported for 2005 was 8.5. Those in facilities with between 5 and 9 O.R. suites were paid on average $69,744. Hospitals with between 15 and 19 O.R. suites paid their O.R. staff the most, at $88,333.

Nearly half (48 percent) of our respondents work in a facility that has more than 30 employees in the O.R. department, though this is down from last year’s figure of 57 percent. This year there were a few more departments with between 21 and 30 employees (16 percent), as well as with just 1 to 5 employees (5 percent).

Similar to last year, most of our respondents report either to the O.R. Director or the Nursing Director – in fact these two were tied as "most reported to" at 21.4 percent for 2005. Our survey showed an increase in the number reporting directly to the Director/Manager Materials Management, up to 11.6 percent from just 2 percent last year.

When we asked what functions report directly to the O.R. director, we saw a 13 percent decrease in the number of facilities in which decontamination functions are under the O.R. director, for a total of 71 percent. In addition, 10 percent fewer reported that sterile processing functions fall under authority of the O.R. Director, totaling 79 percent for 2005. We added a new category of Ambulatory Surgery Center/Clinic and found that 20 percent of O.R. Directors are responsible for these functions.

Job security and pay raises

Job Security

While most (80%) of our respondents experienced a salary increase over the previous year, this is down three percentage points from our 2004 findings. A surprising 4.5 percent actually said their salaries had decreased from the year prior, another possible explanation for the overall drop in salaries. For those who reported that their salaries had increased, the average amount of the increase was 4.1 percent. Fewer respondents said they expected to receive a bonus as part of their 2005 compensation, 20 percent, versus 28 percent who were expecting a bonus in 2004.

Also telling, there was a significant decrease in the number of respondents who felt "very secure" in their jobs – down to 47 percent from 61 percent in 2004. More of our respondents felt "somewhat secure" in their jobs compared to last year – 46 percent, compared to 37 percent in 2004. And a whopping 7 percent (compared to just 1.85 percent last year) said they felt "somewhat insecure" in their current position.