How Doctors Get Rich

First of all, I’ll just throw a few facts around, and if these facts don’t sober you up, nothing will.

In 1949, there were about 190,000 doctors in the U.S. Now (early 2010), there are about 700,000 doctors and surgeons in the U.S., and they make an average salary of over $200,000.

In 1997, Americans spent a mind-boggling 17 percent of national income on medical care. No other country in the WORLD even comes CLOSE to that level of spending.

In 1996, the average U.S. Physician income was $199,000. The same year (1996), the average income for physicians of countries in the OECD (Organization for Economic Co-operation and Development) was $70,324. Think about that…. In 1996… doctors in the U.S. Made almost 3 times as much as doctors in the rest of the developed world. Would it surprise you to know that the same year U.S. Residents paid about 3 times as much per capita for health care as the rest of the world?

In 1999, the U.S. spent about $988 per person on physician services, while the OECD median was $342.

The really bad news for Americans… Almost all of the OECD nations have better health care than the U.S. does. The U.S. pays almost three times as much and the Health Care they receive is not as good as most of the developed world.

But… how do doctors get rich? Doctors in America (and most of the world) get rich by having sick patients, while a doctor whose patients are healthy goes broke. Does this sound like a sensible arrangement to you? Shouldn’t doctors who keep their patients healthy make more money than doctors who have sick patients?

How to fix it? The idea is fairly simple, but would be a radical change. Pay our personal physicians to keep us healthy instead of paying them when we are sick. Wow… what a concept…. pay a doctor more if he/she does their job well instead of paying them more if they don’t. You mean “Pay for Performance”?

First of all, because of the incredibly high wages doctors are paid in the U.S., there seem to be two main categories of doctors in this country. There are those doctors who genuinely care about their patients and want to keep them healthy. These doctors will always do a good job for their patients, and I hope they are the majority of doctors, although I am not sure of it. The second group of doctors are the ones who are in it only for the money. They went to Med School because they wanted to be rich. Wouldn’t it be a good thing if those doctors had monetary incentives to keep their patients healthy?

How about this? Pay doctors more when their patients are healthy…

If every person in this country chose a primary care physician whose job it is to keep them healthy, and this primary care physician was paid monthly for that patient, but the payments stopped if the patient became ill wouldn’t that force ALL primary care physicians to develop pro active methods of keeping their patients healthy? Even the doctors who are only interested in the money? How about if the monthly payments stopped and a monetary penalty was applied when his patients became sick, and the penalty went up if the patient had a disease that was preventable?

Imagine it: Your primary care physician is paid a fixed dollar amount per month per healthy patient under his care. If a patient is sick at any time during the month, the doctor is not paid for that patient. Under this arrangement, the doctor who cares about his patients is rewarded for it, and even doctors who just want to make money are forced to be pro active about keeping their patients healthy. Doctors could be rated on the percentage of healthy patients they have and given bonuses for having high percentages of healthy patients. Perhaps a new category of health care worker should be commissioned; something between a doctor and nurse. This new category of health care professional would be responsible for educating their patients on how to stay healthy, and compensation tied to the general health of their patients.

The fact is that I am always impressed by the restraint most doctors show. Under the current financial system your doctor is working against his/her own financial interests every time they give you advice that keeps you healthy. I’m actually surprised that we don’t have doctors taking out ads telling you to eat more junk food, drink more soda, consume more salt, and please don’t ever exercise! It would make financial sense for the doctor. We need to change this.

Doctors interests need to be aligned with the interests of their patients. It’s just COMMON SENSE.