Physicians

Making A List and Checking It Twice

Goozner Allow me to call readers attention to an article in the latest issue of the New England Journal of Medicine that calls on medical specialty societies to make lists of the five most wasteful practices in their sub-specialties and develop programs to educate their colleagues about how to cut back on these wasteful practices.

Howard Brody, who heads the Institute for Medical Humanities at the University of Texas Galveston Branch Medical School, points out that most stakeholders in health care reform — the drug companies, the insurance companies, the medical device companies, taxpayers, Medicare beneficiaries — have been asked to give up something to insure the uninsured. But physicians?

Although major professional organizations have endorsed various reform measures, no promises have been made in terms of cutting any future medical costs. Indeed, in some cases, physician support has been made contingent on promises that physicians’ income would not be negatively affected by reform.

It’s appropriate to question the ethics of this stance, he writes.

To honor Dr. Brody’s excellent suggestion, allow me to throw the following information into the mix, courtesy of the annual American Medical Group Association physician salary survey. What follows are the median (50 percent earn more, 50 percent earn less) salaries for the six highest-paying and six lowest-paying medical specialties in 2009:

Five Highest

Orthopedic surgeons —                         $580,711 to $641,728

Cardiac and thoracic surgeons —           $507,143

Radiologists —                                     $438,115 to $478,000

Radiation therapy —                             $413,518

Gynecological oncology —                    $406,000

Cardiology —                                       $398,034

Five Lowest

Family Medicine —                               $197,655

Pediatrics —                                        $202,832

Internal Medicine —                              $205,441

Psychiatry —                                       $208,462

Geriatrics —                                         $211,425

Hospitalists —                                      $211,835

(For the full list, click here.)

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klonopin genericativan genericBfQcvhkWOjSick of the whiningAcai Berry Recent comment authors
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ExhaustedMD
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ExhaustedMD

Re Sick of the whining’s comment above: You missed the point of my comment per your reply. Maybe a good portion of what causes people to live or die are the choices they make that then brings them into the office, expecting us to save their lives after they have compromised it beyond repair. And, guess what, Sotw, a sizeable amount of patients do think we can overcome the odds and restore their health as only a God could do, and then sue us when we aren’t able to succeed. So, my point to my comment is I am only… Read more »

Sick of the whining
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Sick of the whining

ExhaustedMD –
“Higher standard of accountability because of what the MD degree creates”
You and your colleagues are held to higher standards of accountability because what you do causes people to live or die, not because of the letters after your name. Kind of missing the forest for the trees, aren’t you?

Acai Berry
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Kate DuBois
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As a consumer whose healthcare insurance is going up again and someone who can’t afford the deductible right now to repair a botched foot surgery, I’m glad this issue of physician accountability is being addressed in a public forum. This isn’t sour grapes, as I’m very grateful for the excellent care I received with a previous cancer diagnosis (clean bill of health now, TG) but I just finished reading a new book, Bend the Health Care Trend, that opened my eyes to the value of a consumer driven healthcare plan (CDRP). A CDRP would increase physician transparency and accountability. This… Read more »

Dr. Rick Lippin
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I am going to do some triagulation here and give primary care a way to save money. It has been known (but denied) for decades that up to 80% of visits to primary care docs are stress related. So for many years I have been unsuccessfully petitioning JCAHO to add the following to their standards. Here are two simple mandatory questions that need to be asked by your primary doctor during every patient visit. If your doctor does NOT ask these – find another doctor.These questions will change US medical practice and save a lot of money. TWO SIMPLE MANDATORY… Read more »

Anonymous
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Anonymous

There are also those exhausted women in Bangladesh etc who travel for miles to cut wood, care for house, do odd jobs to earn livelihood and pamper drunk husbands. They don’t make that kind of money for being on hook 24X7.
No link is being made doctor salary and cost cutting, though it is inevitable there will be some impact.
May I ask this question- since doctors are so overworked would they welcome import of foreign doctors to relieve this burden on their shoulders?

Doc99
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Doc99

I am so underpaid!

ExhaustedMD
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ExhaustedMD

First of all, in response to jd after my last posting above, I don’t understand your reply to my income, based on how many years I have practiced. I read of employment postings for the past 5 years that quote incomes of 200K or more at the start of the job in my field, and it doesn’t note limitations to the number of years in practice to apply for the job, so the number of years one is practicing does not greatly diminish income opportunity, at least of late. Also, I disagree with your comment that all income posted for… Read more »

MG
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MG

Barry – If you stood up in front of a room of physicians and made those comments (even though there is alot of underlying true to them), they would come after you with picks and torches. Physicians are unfairly demonized because of the salary they make and freshly graduated MDs do have some legitimate issues about their large debt burdens. Still, it is hard for me to listen to physicians (especially specialists) largely cry ‘wolf’ about their income. By any rational measure whether it is physicians in any other country or by most occupations in this country, physicians are among… Read more »

Vikram C
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Vikram C

Actually there is this interesting section in the reform bill- SEC. 1128H. FINANCIAL REPORTS ON PHYSICIANS’ FINANCIAL RELATIONSHIPS WITH MANUFACTURERS AND DISTRIBUTORS OF COVERED DRUGS, DEVICES, BIOLOGICALS, OR MEDICAL SUPPLIES UNDER MEDICARE, MEDICAID, OR CHIP AND WITH ENTITIES THAT BILL FOR SERVICES UNDER MEDICARE. I would like to know the same about my doctors. At least for my dermatologist who prescribed me $351 medicine for spots on my neck that I was able to home-cure using $3 anti-dandruff Equate shampoo from Walmart and faced no side effects of steroids that I would have encountered with prescribed medicine. This might make… Read more »

John Ballard
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John Ballard

I wish these discussions would make a distinction between profit and professional compensation. They are not the same. “Profit” is a business term describing the bottom line of a P&L statement. It may be operational profit, pre-tax profit or net profit. And it may be payable as money, dividends, stocks or options. “Compensation” is a business expense. In addition to the paycheck, it includes whatever benefits may be included. Part of the confusion derives from physicians being better at medicine than at business, leaving business details to other professionals (like lawyers, CPA’s or tax accountants). It is revealing that an… Read more »

Vikram C
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Vikram C

Margalit, Every time employee base shrinks while the work doesn’t that’s a sacrifice made by remaining employees. Now what insurance does with new found saving is another issue. This may just make a small dent into costs and may not be enough to reduce premiums. However no one is trying to reduce premiums. We can only slow down their growth rate to that of inflation rate. And if all stakeholders can do little bit that just might be enough. Hence the pertinent question to doctors in the article- what are they doing and how are they contributing? I fully agree… Read more »