Doctors are not paid enough for their services

There has been a public belief for decades that doctors are among the wealthiest in the country, and that they are overpaid for their services. Those who care to pay attention to the evolution of the health system are also aware that payments for physician services have progressively slashed by insurers.

That being said, the majority of my patients still have a poor understanding about how doctors are paid and the work that goes into being a healthcare provider. I have overheard comments from patients that go along the lines of this:

“These doctors spend less than 10 minutes with me and I get hit with a bill for a few hundred dollars. They have it all good.”

“She always wears such fancy clothes. Docs have so much money.”

“I work just as hard as this doc. Why does she get paid so much more than me?”

While this is just a slice of what I’ve only heard, it is clear that much of this stems of ignorance. I will analyze the topics to clear the air:

1. What you see on your bill is not what your doctor gets to keep. For instance, you may see what your doctor billed your insurance company $300 for your care. In a fee-for-service model, the contracted rate may only be $130. The billing company may then take another 3-5% for its services in helping the doctor collect from the insurance company. If the doctor is unlucky, the insurance company may even deny/reject a claim due to documentation issues and get nothing. After everything is done, the practice collects maybe $125. That amount goes toward paying for the clinic’s utilities, front desk person, technician, computer systems, diagnostic equipment, cleaning services, and all other costs relating to operating the clinic. I’ve seen practices with operational costs in the 90+% range. If your doctor is employed by the practice, another cut may be taken out by the practice owners. Maybe if your doctor is reimbursed more appropriately, then she might actually have more time to spend with you.

2. While it is your doctor’s own business what she wears to work, would you consider your doctor to be less competent if she were disheveled and wore dirty clothes? What if the fancy-appearing clothing were actually purchased third-hand at a thrift shop? I have certainly had patients with life-threatening medical conditions who refused to pay the $20 copay but was willing to own fancy iPhones, Ray-Ban sunglasses, bling, or even get $100 massages. Ultimately it all lies in where your priorities are.

3. There are very few good paying occupations that aren’t challenging in some form (physical or mental). As a plumber I can bill for $100 an hour and even include the time it takes me to find a part that I need in the store (and I can charge you for the part). The 30 seconds of medical decision making that a doctor undergoes took many years (a decade) of sacrifices to learn. Even after making that decision, there are still ramifications that has to be considered. It doesn’t end. Obviously there is a price placed on a doctor’s ability. There’s also a fine line to what a doctor is worth. What should be known is that if that value of a doctor is discounted enough, those who are most competent will quit.

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