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Do Doctors Make Fair Pay  Term Paper

¶ … doctors make too much money, and if so, what is a fair wage for doctors. Do doctors make too much money? Many people think so. In fact, doctors are one of the highest paid occupations in the United States. What do they actually do for all that money? Many dissatisfied patients would say that they run their practices like factories, do not spend enough time with them, and their staff can be rude and disinterested. They would also note that doctors who treat their patients like robots make far too much money, especially for the service they offer. Everyone knows that doctors are some of the highest paid professionals in this country. Specialists in certain areas can make almost $1 million dollars a year, and even the newest physicians regularly rake in over $100,000 a year after only three years in practice. Even the lowest paid doctors around the country average $150,000 or more a year, and that goes up as their experience increases (Editors). Is this too much money? If you have ever sat in a doctor's office for hours on end, waiting for an "appointment" that runs an hour or more late, you are sure to have an opinion on what type of salary your doctor makes, and whether they are worth it. Many doctors treat their patients perfunctorily, meeting with them for less than five minutes, prescribing drugs to treat illness instead of looking for other options, and running their practices like factories, rather than places where patients can receive high-quality health care. Much of that is because the physicians today rely on health insurance and government health care like Medicare for most of their revenues, and they are not fully reimbursed for their services, so they cut corners wherever they can. A physician himself, author Kevin Pho writes, "The number of physicians who do not accept new Medicare patients is dramatic; in states like Texas, this number can exceed 40%. No wonder, as Medicare pays less than half of doctors' fees" (Pho 09a). Medicare is not the only problem. Most H. MOs and other insurance providers only pay certain amounts for certain procedures, which means if the doctor spends too much time with a patient, they will not be reimbursed for their time, and businesses cannot keep on in business if they are not reimbursed fairly. Even so, doctors make good money, no matter how much they are reimbursed, and especially when you factor in their hours, which are usually nine to five with at least an hour for lunch, often closed or only open half a day on Friday, and off on the weekends.

Because of the perception by many that physicians make too much money and spend too little time with patients, some insurance providers have developed different pay structures to encourage physicians to become more involved with their patients. A group of physicians write about a plan in Hawaii, where physicians were paid according to their performance. They were rated by their patients, who rated them on several factors, and those with the highest ratings received more pay than those with lower ratings. The physicians joined the program voluntarily. The doctors write, "Physicians who chose to participate in the PQSR program were compensated with a direct financial reward that was calculated by ranking each practitioner's overall score on all program components relative to the scores of other participating practitioners that fall into the same attainable score range" (Gilmore et al. 2144). Most of the physicians in the program said they were happy with it, and with the results, and in fact, participation in the program grew every year it was offered, as more physicians found out about it and decided to join. This pay for performance model seems like it is a win-win for the patient and the physician. The physicians earned more when they did their jobs effectively, and the patients felt they were getting better treatment as a result of the program. This would be a good way to weed out physicians who practice "factory" medicine and do not spend enough time with their patients, and it is a good way to reward physicians that actually care about their patients and their health care needs.

Another clue that doctors make far too much money is their lifestyle. Most doctors live in large, extravagant homes, drive expensive cars, and they are members of country clubs or other elite clubs, that only some of the wealthiest people can afford. They live this way because they are compensated quite fairly for their work,...

While this certainly is not the case for all doctors, especially young doctors that are new to their practice, it is true for a majority of doctors. They live well because they are compensated quite well for their work, and to many, this means they are actually overcompensated, especially when their hours and ease of work is taken into account.
Another aspect of the physician pay scale is the number of physicians there are in the United States. There are millions of doctors throughout the country, and their numbers are increasing. Another expert notes, "Over the next eight years, medical schools are aiming to boost enrollment by as much as 30% above 2002 levels. More than a dozen new medical schools are being built or considered, and many of the nation's 125 existing schools are planning to expand" (Brownlee 36). This means there will be even more physicians in the country, making even more money as the Baby Boomer generation starts to age and require more medical treatment. Author Brownlee talks about the prevalence of fewer hours and higher pay even for younger doctors, too. She writes, "Add to that a decline in the number of hours physicians are willing to put in each day and a few incipient signs of a shortage (notably longer waiting times for appointments and rising salaries for young doctors)" (Brownlee 36). Thus, as older physicians retire and younger ones come in to take their places, these younger physicians will start with higher salaries, work fewer hours, and still end up making even more than their predecessors did. All of this points to a medical community that is overcompensated, under utilized, and not serving their patients as well as they could.

Research indicates that doctors know they are going to be well paid, and they will not settle in areas that could result in lower salaries for them. Author Brownlee continues, "Physicians tend to congregate in places where incomes are higher and patients are more likely to be insured. (And to be sure, physicians are in short supply in parts of the country where relatively few people have health insurance, especially rural areas)" (Brownlee 37). Thus, doctors do not live where they know they will not make enough money, leading to shortages in health care in the areas that need it the very most. Many doctors go into medicine not because they want to help people, but because they know they can make a lot of money, and that is really not a reason to choose the healthcare profession. It used to be that doctors became doctors because they wanted to help people, and they wanted to heal people. Now, there are many doctors treating patients every day who really do not care about those patients and their needs, they only care about the money, and it often shows in their treatment. Doctors make too much money for what they do, and when they keep people waiting for hours, give them shoddy treatment, and do not really listen to their symptoms, they are doing the entire profession a disservice.

On the other hand, there are many who believe physicians really do not make enough money, and they are not all just physicians. Congress has recognized that physicians should not be the target of reducing medical costs -- that rests on the insurance community. Doctor Pho says, "While the common perception is that the medical profession is well-compensated, there are serious implications in targeting physician pay to control medical spending" (Pho 09a). It is well-known that doctors are not compensated fully for many of their services by Medicare and many insurance companies, and any other company would go bankrupt under such conditions, yet doctors are supposed to continue operating, no matter what. In fact, while many studies show that doctors' salaries are increasing, when it comes to reimbursement and inflation, they are actually losing money. Another author writes, "Last month, for instance, the Washington-based Center for Studying Health System Change reported that the average net income for doctors dropped 7% after accounting for inflation from 1995 to 2003" (Romano 17). So in fact, doctors are making less, and receiving less, while the general perception is that they are making more and working less. Doctor Pho says, "Princeton economist Uwe Reinhardt estimates that physicians' take-home pay represents roughly 10% of national health care spending. Cutting physician pay by 20% would only reduce spending by…

Sources used in this document:
References

Brownlee, Shannon. "Overdose: The Health-Care Crisis No Candidate Is Addressing? Too Many Doctors." The Atlantic Monthly; Dec. 2007. 36+.

Editors. "Physician Salary Survey." Physician Search.com. 2009. 12 Oct. 2009.

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Gilmore, Amanda S., et al. "Patient Outcomes and Evidence-Based Medicine in a Preferred Provider Organization Setting: A Six-Year Evaluation of a Physician Pay-for-Performance Program." Health Services Research; Dec. 2007, Vol. 42 Issue 6. 2140-2159.
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