NYT: Doctor's Salaries Are Not the Big Cost

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Arkangeloid

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http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html

As always, stay away from the comments unless you want to lose what remains of your sanity.
Good, if we're going to truly start discussing about costs and where every cent of reimbursement is eventually going to then this goes to the heart of things: overhead and administrative salaries.

My favorite part:
It’s worth noting that the health care industry is staffed by some of the lowest as well as highest paid professionals in any business. The average staff nurse is paid about $61,000 a year, and an emergency medical technician earns just about minimum wage, for a yearly income of $27,000, according to the Compdata analysis. Many medics work two or three jobs to make ends meet. “It’s stressful, dirty, hard work, and the burnout rate is high,” said Tom McNulty, a 19-year-old college student who volunteers for an ambulance corps outside Rochester. Though he finds it fulfilling, he said he would not make it a career: “Financially, it’s not feasible.”

Nothing is sweeter than comparing a hospital CEO executive's salary to an EMT. I knew the liberal weapon of "income inequality" would eventually come to good use.
 
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I never thought I'd see the day when Elizabeth Rosenthal stopped attacking physicians
 
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I never thought I'd see the day when Elizabeth Rosenthal stopped attacking physicians
Thought the same thing too. Maybe she exhausted the number of specialists she could attack? Hard to attack Neurosurgeons and get sympathy and brandishing of pitchforks like you can when you demonize Derm, Ophtho, Radiology, GI, Anesthesiology, EM, etc.
 
Nice contribution, Ark.

"Doctors are beginning to push back: Last month, 75 doctors in northern Wisconsin took out an advertisement in The Wisconsin State Journal demanding widespread health reforms to lower prices, including penalizing hospitals for overbuilding and requiring that 95 percent of insurance premiums be used on medical care. The movement was ignited when a surgeon, Dr. Hans Rechsteiner, discovered that a brief outpatient appendectomy he had performed for a fee of $1,700 generated over $12,000 in hospital bills, including $6,500 for operating room and recovery room charges."

Very nice work.

Looks like future doctors are gonna have to be more than just book smart.
 
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Nice contribution, Ark.

"Doctors are beginning to push back: Last month, 75 doctors in northern Wisconsin took out an advertisement in The Wisconsin State Journal demanding widespread health reforms to lower prices, including penalizing hospitals for overbuilding and requiring that 95 percent of insurance premiums be used on medical care. The movement was ignited when a surgeon, Dr. Hans Rechsteiner, discovered that a brief outpatient appendectomy he had performed for a fee of $1,700 generated over $12,000 in hospital bills, including $6,500 for operating room and recovery room charges."

Very nice work.

Looks like future doctors are gonna have to be more than just book smart.
I think commenter PointertoVoid needs a swift kick right where he voids.
 
It's really hard for me to motivate myself to read comments. What I love about SDN is the average IQ has to be at least reasonable..can you link us to this individual comment?

"The author has completely missed the problem. It's not that MDs are overpaid compared to their overpaid hospital and insurance executives. It's that MDs and administrative executives are ALL overpaid.

The simple fact is that healthcare in this country, because it's a for profit endeavor by hospitals, insurance companies and yes MDs, costs way too much and delivers way too little. MDs' salaries must come down ALONG WITH hospital/insurance executives' salaries. Single-payer is the only answer."
 
It's really hard for me to motivate myself to read comments. What I love about SDN is the average IQ has to be at least reasonable..can you link us to this individual comment?

You asked for it lady.

Derp said:
The author has completely missed the problem. It's not that MDs are overpaid compared to their overpaid hospital and insurance executives. It's that MDs and administrative executives are ALL overpaid.

The simple fact is that healthcare in this country, because it's a for profit endeavor by hospitals, insurance companies and yes MDs, costs way too much and delivers way too little. MDs' salaries must come down ALONG WITH hospital/insurance executives' salaries. Single-payer is the only answer.
 
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My other favorite from AJ (likely a Hospital executive with an MBA only):

"This is an absolutely ridiculous article for the New York Times to be publishing. What matters is not so much what an INDIVIDUAL makes, but rather what the entire CLASS of professionals make. Undoubtedly salaries of executives are quite high, but the sheer number of doctors means that their cost impact is far greater on the medical system than the impact of executives. That is not to say that executives should be given a free pass, but this article does seem give a free pass to doctors and their salaries. We are at a stage in our healthcare system where nobody should be given a free pass. The author of this piece should understand this basic concept and write something a bit more substantial and valuable."

Nice how at least in this article, doctors can sit on the other side of the table for once.
 
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My other favorite from AJ (likely a Hospital executive with an MBA only):

"This is an absolutely ridiculous article for the New York Times to be publishing. What matters is not so much what an INDIVIDUAL makes, but rather what the entire CLASS of professionals make. Undoubtedly salaries of executives are quite high, but the sheer number of doctors means that their cost impact is far greater on the medical system than the impact of executives. That is not to say that executives should be given a free pass, but this article does seem give a free pass to doctors and their salaries. We are at a stage in our healthcare system where nobody should be given a free pass. The author of this piece should understand this basic concept and write something a bit more substantial and valuable."

Nice how at least in this article, doctors can sit on the other side of the table for once.

wtf lol that commentator obviously hasn't been reading the new york times for the past few months
 
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The 19 year EMT volunteer who is not going to be an EMT because of the low salary would be severely censured had he said "I'm going in to medicine... It's a great profession that will pay me well ."
 
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As always, stay away from the comments unless you want to lose what remains of your sanity.

Oh, that's LONG GONE. Let me take a look here. It really can't be that ba . . .

grandpa-simpson-arrives-and-leaves_49.gif


Edit: Actually, as long as I stay away from the general comments section, it's not that bad.
 
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SDN needs a community NYT account for trolling the comments section.
 
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Ugh I read the comments... Why do I do this to myself?

What I don't get is the multiple comments saying well yea these admins make tons of cash but there's only a few 100 of them, compare that to 900,000 physicians... So in your mind it's ok that the collective salary of 900,000 is comparable to a few 100? Isn't that saying something that they are even in the same league?

Oh well these CEOs have very special skills and work crazy hours, not many people can do what they do... I'm sorry I didn't realize being a physician didn't meet those same requirements. Let your gardener cut you open next time. Ridiculous.
 
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Oh well these CEOs have very special skills and work crazy hours, not many people can do what they do... I'm sorry I didn't realize being a physician didn't meet those same requirements. Let your gardener cut you open next time. Ridiculous.

This. So very much. Does these administrators realize that without the physicians and other healthcare professionals, there'd be no healthcare business to "administer"? And why do the purveyors of the product have to tighten their belts, but the profession that could be most easily reduced if they did research and streamlined their processes is somehow a sacred cow that cannot be touched?
 
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I think getting on some comments boards and arguing (aggressively but accurately) the facts against these know-nothings might be beneficial, for the sanity of those of us in medicine if nothing else
 
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I think getting on some comments boards and arguing (aggressively but accurately) the facts against these know-nothings might be beneficial, for the sanity of those of us in medicine if nothing else

Same here.


Also i feel like most of the administration have far less schooling than we do. One of the GI docs at my school, her speech during GI specialty info session involved complaining about how she takes orders from high school graduates in administration and how frustrating that is..
 
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I think getting on some comments boards and arguing (aggressively but accurately) the facts against these know-nothings might be beneficial, for the sanity of those of us in medicine if nothing else

I used to try doing this, but it just startedto feel like I was slamming my head into a brick wall over and over.
 
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The author of this piece should understand this basic concept and write something a bit more substantial and valuable.
5ce4.jpg
 
The part about 95% of insurance reimbursement to cover the actual fee of the medicine being practiced sounds like a cool idea. Similar to the 85% of all insurance premiums collected must be paid out to the consumers of said insurance argument that was made for insurance companies recently.

I mean, I think doctors would be willing to compromise to like 75% of all insurance reimbursement should go to those doing direct medical care (Doctors and Nurses)
 
The part about 95% of insurance reimbursement to cover the actual fee of the medicine being practiced sounds like a cool idea. Similar to the 85% of all insurance premiums collected must be paid out to the consumers of said insurance argument that was made for insurance companies recently.

I mean, I think doctors would be willing to compromise to like 75% of all insurance reimbursement should go to those doing direct medical care (Doctors and Nurses)

Even cooler idea: cut insurance companies out of the picture and have 100% of health care fees go to paying for health care.
 
This. So very much. Does these administrators realize that without the physicians and other healthcare professionals, there'd be no healthcare business to "administer"? And why do the purveyors of the product have to tighten their belts, but the profession that could be most easily reduced if they did research and streamlined their processes is somehow a sacred cow that cannot be touched?

Oh, if one is a higher-up administrator, they not only grasp this...but are rather planning their strategies 5 steps ahead of everyone else.

In other words, in their field, one does not succeed by playing fair (eg in determining employee valuation based on education or function) and not exercising strategy at every decision.
 
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Oh, if one is a higher-up administrator, they not only grasp this...but are rather planning their strategies 5 steps ahead of everyone else.

In other words, in their field, one does not succeed by playing fair (eg in determining employee valuation based on education or function) and not exercising strategy at every decision.

Oh man, just caught the typo in my post. Subject verb agreement is hard yo.

Second, I don't doubt that's the way of it, but at no point does such an approach to medicine encourage better outcomes for patients, collegiality among the healthcare providers or reduced costs along the way. It basically ensures the administrative burden and bureaucratic malarkey are going nowhere.
 
The author of this piece should understand this basic concept and write something a bit more substantial and valuable.
5ce4.jpg
Huh? Substance doesn't win minds over. Emotion does.
 
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The worst thing to happen to healthcare is the premise that everyone should have equal access to it regardless of their (our societies) ability to pay for it. That is the source of almost all the negative politics/battles/negative attitudes towards physicians/hit-pieces that pop up.

I hate this notion of universal coverage most because it makes the people delivering healthcare into a "problem" rather than an asset. John-Q-Public owns the physician and has a vested interest in their nominal compensation rather than making a value judgement when they have the opportunity of purchasing an individual healthcare service.
 
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Someone has read Schopenhauer.

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Haha. I can't bear another gender discussion thread but here are some of his gems:

"One need only look at a woman’s shape to discover that she is not intended for either too much mental or too much physical work. She pays the debt of life not by what she does but by what she suffers—by the pains of child-bearing, care for the child, and by subjection to man, to whom she should be a patient and cheerful companion. The greatest sorrows and joys or great exhibition of strength are not assigned to her; her life should flow more quietly, more gently, and less obtrusively than man’s, without her being essentially happier or unhappier."

"Women are directly adapted to act as the nurses and educators of our early childhood, for the simple reason that they themselves are childish, foolish, and short-sighted—in a word, are big children all their lives, something intermediate between the child and the man, who is a man in the strict sense of the word. Consider how a young girl will toy day after day with a child, dance with it and sing to it; and then consider what a man, with the very best intentions in the world, could do in her place."

Anyway, even the Greeks knew that rhetoric could be more powerful than truth. Scary but it's so.
 
Haha. I can't bear another gender discussion thread but here are some of his gems:

"One need only look at a woman’s shape to discover that she is not intended for either too much mental or too much physical work. She pays the debt of life not by what she does but by what she suffers—by the pains of child-bearing, care for the child, and by subjection to man, to whom she should be a patient and cheerful companion. The greatest sorrows and joys or great exhibition of strength are not assigned to her; her life should flow more quietly, more gently, and less obtrusively than man’s, without her being essentially happier or unhappier."

"Women are directly adapted to act as the nurses and educators of our early childhood, for the simple reason that they themselves are childish, foolish, and short-sighted—in a word, are big children all their lives, something intermediate between the child and the man, who is a man in the strict sense of the word. Consider how a young girl will toy day after day with a child, dance with it and sing to it; and then consider what a man, with the very best intentions in the world, could do in her place."

Anyway, even the Greeks knew that rhetoric could be more powerful than truth. Scary but it's so.

While true, no one that I've seen so far addresses in a literary for how to use emotion to win arguments over truth and substance.

Sorry for going off subject :-\

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Anyway, even the Greeks knew that rhetoric could be more powerful than truth. Scary but it's so.

True, but history has been much less kind to the sophists than to the thinkers who used substance to defend their agendas. Even today, accusing someone of "sophistry" is a clear insult. That said, you're right in that sophistry (sadly) wins over the masses very routinely in the political arena.
 
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True, but history has been much less kind to the sophists than to the thinkers who used substance to defend their agendas. Even today, accusing someone of "sophistry" is a clear insult. That said, you're right in that sophistry (sadly) wins over the masses very routinely in the political arena.
Not sure this is the right thread but all the spin discussion/government threads remind me of this brilliance -
 
True, but history has been much less kind to the sophists than to the thinkers who used substance to defend their agendas. Even today, accusing someone of "sophistry" is a clear insult. That said, you're right in that sophistry (sadly) wins over the masses very routinely in the political arena.

The great propaganda artists figured out how to play both cards. Let me stir you with emotions and whoo you with statistics.
 
Those comments doe. The sad thing to me is that the average NY Times reader is not the average American. NYT readers are typically a better crowd than the riff raff that get their news from CNN or Yahoo. It concerns me that even these folks have such a skewed view of our profession. We're in for a helluva ride.
 
Haha. I can't bear another gender discussion thread but here are some of his gems:

"One need only look at a woman’s shape to discover that she is not intended for either too much mental or too much physical work. She pays the debt of life not by what she does but by what she suffers—by the pains of child-bearing, care for the child, and by subjection to man, to whom she should be a patient and cheerful companion. The greatest sorrows and joys or great exhibition of strength are not assigned to her; her life should flow more quietly, more gently, and less obtrusively than man’s, without her being essentially happier or unhappier."

"Women are directly adapted to act as the nurses and educators of our early childhood, for the simple reason that they themselves are childish, foolish, and short-sighted—in a word, are big children all their lives, something intermediate between the child and the man, who is a man in the strict sense of the word. Consider how a young girl will toy day after day with a child, dance with it and sing to it; and then consider what a man, with the very best intentions in the world, could do in her place."

Anyway, even the Greeks knew that rhetoric could be more powerful than truth. Scary but it's so.
Arkangeloid is that you?
 
Those comments doe. The sad thing to me is that the average NY Times reader is not the average American. NYT readers are typically a better crowd than the riff raff that get their news from CNN or Yahoo. It concerns me that even these folks have such a skewed view of our profession. We're in for a helluva ride.
Exactly. Even the more educated NYTimes reader doesn't even understand how simple health insurance works. They think their copay pays for medical services. :bang:
 
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