Tuesday, August 12, 2008

Physician payment - Are Doctors Paid Enough?

When asked, “Do doctors make too much money?”, the wife of a well-known Minneapolis surgeon, used to reply, “They don’t make enough..”

With her reply in mind, I bring your attention to a July 17 piece in www.healthleadersmedia.com. “Are Doctors Underpaid?’ In it, Phillip Miller, vice-president of communication for Merritt Hawkins & Associates, a physician search firm, a division of AMN Healthcare, Inc, argues that while certain specialists are paid well, most primary care practitioners are not.

Miller observes.

• In 2007, salaries offered certified nurse anesthetists ($185,000) exceeded those of general internists ($176,000), family physicians ($172,000), and pediatricians ($159.000).

• Salaries offered to orthopedic surgeons, radiologists, and cardiologists, averaged $408,000 and surpassed average salaries offered to general internists, family physicians, and pediatricians ($169,000) by a factor of nearly 2 ½ to one.- a striking disparity fueling the primary are shortage.

• Among government and private plan officials, the pressure to cut physician reimbursement is unremitting because these officials know the public will not object because of the perception that most doctors are wealthy (as an aside, I don’t believe this belief will change until access to care is sharply cut).

• Many doctors, particularly primary care physicians, can argue with justification they are underpaid, given their educational debt of $150,000 or more, their 11 years or more of collegiate and post-collegiate education, their high malpractice premiums, and their relentless rising practice costs, many secondary to rules and regulations.

• Given the benefits they bring to society, physicians provide services worthy of high rewards, compared to more highly paid professionals.

• Doctors other than primary care physicians cannot argue they are underpaid (they rank in the upper middle class in income), but most doctors in all practice categories suffer from under empowerment -
unable to raise fees, submitting bills to third parties that are often not paid, and unable to pursue a course of treatment that must be approved by someone far removed from the treatment scene.

• Many physicians are looking for a way out of traditional practice settings – by taking non-clinical jobs, retiring, working as temps. And avoiding third parties by accepting only direct payment.

I recommend you read the full-text of Miller’s message by going to www.healthleadersmedia.com or respond to him directly at pmiller@mha.com.

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