A Blog on National Doctor’s Day

Honor a physician with the honor due onto  him, for the uses  of which ye may have of him.

Ecclesiasiticus

It is an art, based to an increasing extent on the medical sciences but comprising much that still  remains outside the realm of any science.

Francis Peabody, MD (1881-1927), Care of the Patient

March 30, 2012 -  Do doctors make too much?  It’s an age-old question. Doctor often submit their fees when many patients are most  vulnerable and patients may not have enough information to judge their doctors  or to ask them to justify their charges.   This, being National Doctors Day, is an appropriate time to revisit the question: Do doctor make too much?   I don’t know, but I recall  a surgeon’s wife telling me:  “They don’t make enough.”

Do Doctors Make Too Much? Something to Think About on National Debate on Health Reform

By Phillip Miller, VP of Communications, Merritt Hawkins and Associates, Irving, Tecxas

“Imagine if every January your employer or your top client threatened to cut your earnings by as much as 30 percent."

"That’s the bind physicians are in today, with no resolution in sight. Because of cost overruns, federal law requires that cuts be made to physician Medicare fees in order to balance the ledger. Each year Congress delays the cuts, but they continue to loom, and everyone knows something has to be done about it. A commission that advises Congress recently came up with a plan for fixing the problem. It suggested that Medicare fees to physician specialists be cut by six percent for three years and then be kept flat thereafter."

"While Congress hasn’t agreed yet on how much physician pay should be reduced, the idea that doctors can afford a financial hit appears to be generally accepted. The fees doctors are paid by both government and private payers have been flat or declining for years, while practice expenses have increased. Many physicians have had to see more patients just to tread water. Thousands have given up on private practice altogether and have become hospital employees. There even have been recent reports of doctors going out of business."

"So far, however, no one is protesting in the street. After all, everyone knows doctors make too much."

But Do Doctors Make Too Much?

"Or do they? Primary care physicians such as family doctors and internists earn an average of about $180,000 a year. That’s after completing four years of college, four years of medical school, and three to four years of residency training. Typically, they accumulate $150,000 or so in debt in the process. Though they make a good income, primary care doctors still have to sweat their mortgages, worry about college tuition, and live the comfortable but constrained lives of normal middle class people. That fancy yacht at the marina or luxury car in the parking lot does not belong to your local FP."

"Medical specialists are in a different category. They typically earn $250,000 to $400,000 a year, and some earn considerably more. This puts them in the same general class as successful attorneys, stock brokers, corporate executives, bankers and entrepreneurs. Unlike other professionals and business people, however, medical specialists have little control over what they charge. In an open market, a top surgeon might be able to charge one million dollars to repair a wealthy hedge fund manager’s heart – and get it. Or, perhaps competition would lower the going rate for quadruple bypass surgery and other complex procedures to a few hundred dollars."

"It is unlikely we will ever know, but I am inclined to think the public would put a high premium on the skills of those who can diagnose illness, repair a heart, reverse cancer, ameliorate pain, restore motor function, or give back to a child her smile. Reducing the rewards given to those with such skills assures that they soon will be fewer in number -- and they already are in short supply. Compensating physicians well is entirely appropriate given the high bar to entry to their profession, the responsibilities they assume, and the lives they save or enhance."

"Just something to think about on March 30 – National Doctor’s Day.”

Phillip Miller is Vice President of Communications for Merritt Hawkins and Staff Care, companies of AMN Healthcare. He can be reached at phil.miller@amnhealthcare.com.

Tweet:   Do doctors make too much? It depends.  Primary care doctors scrambling to survive economically, well-paid specialists saving and improving  lives, or patients benefiting from skills of both and paying doctor bills?