Sunday, December 03, 2006
What's Wrong with this Picture?
A series of articles in the NY Times looks at how family practitioners and emergency room physicians have also jumped over into the cosmetic treatment business because the money is so much better. The message seems to be that being rich isn't enough anymore -- the rich envy the super rich (as one of the editorial notes, " It’s hard for people flying in coach to have much patience with those in first class bemoaning their lack of a personal jet."). But we do need to worry about the effects on society as a whole when members of the educated elite think they are grossly underpaid. The more they feel as if they are losing ground against their peers, the more likely they are to ditch professions in which the pay is only good — like delivering babies — in favor of less useful careers in which the compensation is off the charts — like eliminating lines from wealthy people’s foreheads.
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I don't think this is a "greedy docs" problem. Most primary-care providers (especially those who are serving populations without insurance, or with large proportions of Medicare/Medicaid patients) are neither rich nor super-rich. These folks often carry substantial debt for their training, and it takes years to pay that off at the reimbursement rates many PCPs live with.
Seems to me it makes more sense to address this problem at the level of healthcare reform--that is, why aren't we paying primary care providers for delivering necessary front-line care and counseling around prevention? It's neither fair nor smart to expect bright new docs to enter primary care practice if all the messages our society sends (and let's face it, $$ talks in this context)is that primary care isn't valued.
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