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

jshauser at jshauser at
Thu Sep 10 05:48:47 EST 1998

In article <6t7b2t$kd7 at>,
  sbharris at B. Harris) wrote:
> 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.

Well some of this is changing with the RAPs. Many hospitals are being
reimbursed under capitation, percent of premium, and global fees. The RAPs
are included in these prospective fees and they are seeing their income
decrease!!!!!! I do understand what you mean...jsh


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