Medicine's Ten Greatest Discoveries:Fee-for-Service

Steven B. Harris sbharris at
Wed Sep 9 20:47:09 EST 1998

In <6t605j$45v$1 at> henryj at (George
Conklin) writes: 

>  Accreditation is what limits the number of medical schools
>in the USA, and the number of slots is what keeps wages and
>salaries high upon graduation.  Despite HMOs, the average
>salary (take-home) is still going up.

   No faster than the average inflation adjusted wage.  And slower than
the rate at which medical expenses are going up, which means that
doctors get a lower fraction of the medical dollar than ever (it's now
down to about 20%).  Which you might keep in mind the next time you
wonder why it is that you're getting an MRI scan after only spending 15
minutes with the doctor.  

    Finally, I'd like to note that there is a rather gross disparity in
physician wages.  Family practioners, geriatricians, and pediatricians
make the least money-- basically because we spend more time talking to
patients than the other specialities.  Surgeons make the most.  The
last doesn't bother me, because I've always been of the opinion that
surgeons earn it (in every possible way-- that's a difficult, lonely,
and horribly stressful job with nasty hours and especially difficult
training).  Radiologists, however, make nearly as much as surgeons, and
that *is* a travesty.  At the pediatric hospital near the university
medical center in my city, a guy sitting and reading chest Xrays makes
more money than the surgeons who attempt the repairs on congenital
heart defects in newborns, who are tainted by the low salaries in
pediatrics.  Go figure.  If you're looking for conspiracies, forget the
AMA and find out what gives with the rad people.  All that money, and
they're not very nice, either.

                           With My Usual Smooth Political Sensitivity,

                           Steve Harris, M.D.      

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