Why are doctors so expensive?

That's rather trivial, compared to the $2.26 trillion spent on healthcare in the US annually. Even if it was quadruple that amount, it still only accounts for about 8% of cost.

So are all doctors obstetricians, now? No, of course not. That's a rather meaningless figure, as we're most likely looking at the far edge of the curve.

You're an eye doctor. Why don't you share your numbers with us? You don't have to give us actual income numbers- just tell us the fraction you spend on insurance for your practice vs. the rest of the costs.

[edit]
I found a New York Times article on it:
http://www.nytimes.com/2005/02/22/business/22insure.html

Look at the graph of premiums. Yes, costs are rising quite dramatically, but look at the actual number- $10 billion. That's miniscule compared to the trillions spent annually. In fact, I'd rather see a 0.004% rise in cost due to doctors having to be accountable for killing babies or cutting the wrong pieces off, than get 4 cents back for every $10 I spend.

 

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I am amazed at the finger pointing and distractions physicians throw up in their defense. They try to hide in the details. I would like to see some focus on the real issues in the industry and not the red herrings those in the industry keep throwing out.

http://www.citizen.org/pressroom/release.cfm?ID=1536

Five percent of physicians are responsible for over half of the malpractice clams in The United States. Wouldn't it make more sense to look at physician training and practice to reduce malpractice costs rather than simply forbiding them or forcing the cost of malpractice on patients who are on the receiving end of malpractice?

http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=8308

Rounding up, about 36 billion is spent on medical malpractice each year. That equates to a fraction of 1 percent of physician fees. So this arguement is clearly wrong and has been repeatedly discredited. But it does not keep the AMA from repeatedly brining it up.

http://www.healthbeatblog.org/2008/01/health-care-spe.html

 

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Sure, but in some cases (such as obstetricians and surgeons) malpractice insurance is a major driver of prices. Especially in states without limitations on lawsuits.

I'm not a surgeon, and I have the good fortune to live in a state that caps lawsuits and limits punitive damages. As a result, my malpractice insurance is trivial.

One of the articles I linked to in an earlier post included a story about a woman who had a problem with her pregnancy and it was only the fact that a hospital was just a few minutes away that saved the life of her and her baby. That hospital has since closed due to high malpractice insurance costs and if she had the same problem now, she and her baby would be dead. The point is, high costs associated with malpractice insurance does not always equal increased safely or better outcomes. Sometimes it means less access to care and much worse outcomes.

 

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Mad, why are you still hooked on medical malpractice instead of addressing the cause of medical malpractice? Only five percent of the physicans account for more than 50 percent of the medical malpractice awards. And in aggregate, as pointed out on numerous occasions, total medical malpractice awards amount to less than once percent of the fees physicians charge. I am not getting your logic or rational. How is it a major driver of medical costs? The numbers just do not add up. And of that five percent, many have had multiple awards against them...repeat offenders.

If airline pilots only landed their planes safely 95% of the time or if only 95 % of the pilots could land an airplane we would have serious problems in travel. No one would fly. So why shouldn't the same standards apply to physicians?

 

Part of the reason is because of fucking lawyers. My dad was a surgeon and he got sued one time. He had a patient come into his office that was in the tertiary stage of syphilis. He refused treatment and sent her back to her GP to treat the syphilis before he would touch her. Her GP treated the syphilis and then sent her to another doctor that ended up amputating her foot when it was not necessary. She sued that doctor, but the lawyer also sued my dad just because he saw her one time and did not do a C&S test. His malpractice insurance ended up paying $16,000 to her, which was a lot of money in 1979.

One of my cousins is a radiologist. He tried to save a man that went into cardiac arrest in a public area. The man was too far gone to be saved before the ambulance got there. He was sued because he didn't save his life. His malpractice insurance ended up settling the case for $220,000. This was before the good Samaritan laws came into effect.

You all wonder why doctors are expensive....

 

First, the numbers do not add up as previously noted and proven. Malpractice claims amount to less than one penney for every dollar received by a physician. A small fraction of one percent of total physician fee income is not a huge slice of the expense pie no matter how you slice it.

Two, you cannot sue for failing to prevent deaths...else the industry could not survive. In order to get an award for $220,000 there must be negligence of some sort and their must be a damage.

http://en.wikipedia.org/wiki/Negligence

Without any of the above two items there is no way in hell that anyone is going to be found liable.

 

And if you read, that was before the good Samaritan law went into effect in Kentucky. Second, in both cases, the insurance settled out of court due to fears of a jury possibly awarding dramatically more.

 

There is.
http://www.ratemds.com/social/

Also, you have to factor in the reasons people may choose to become a doctor:
a) To help people
b) For the money

If you remove factor b then significantly fewer people would go through the 10+ years of training required which would be bad for everybody.

 

Good Samaritan Laws protect healthcare providers in emergency situations from being sued if they act reasonably. It does not allow professionals to act irresponsibly or to engage in malpractice.

http://www.medi-smart.com/gslaw.htm

 

Exactly!

 

There are already significantly fewer males entering medical school. My sister-in-law just quit from teaching at Vanderbilt Medical School. She said that there are far fewer males entering med school because of the 10+ years training required.

My dad even discouraged me from going to medical school as he said that one day, this country will have socialized medicine and at that point, it would not be worth it...and he was right.

 

I think that is a pretty solid admission that the AMA has been acting as an agent to errect barriers to competition in the industry and foster an oligopoly if favor of physicans.

Our healthcare system is a wreck today. And who was the architect of that disaster, the AMA favoring physican paychecks at the expense of healthcare, leaving millions uninsured and getting spot treatments in Emergency Rooms.

 

For all of the years of schooling, the expense of it, and for saving and maintaining people's lives, doctors are well deserving of their high incomes.

 

I don't know how folks like Mad reconcile their free market minimal government except in my profession approach to life.

 

Like I said, just google around for five minutes. Here's the first thing I found: http://www.factcheck.org/president_uses_dubious_statistics_on_costs_of.html . If you're really curious, dig into it more yourself and find the relevant studies.

And since the federal government spends about $800 billion on health care each year, your $56 billion figure comes out to about 6.5%; which is in line with all the studies that I have seen claiming that the cost of lawsuits is pretty trivial.

On a side note, capping potential damages in medical malpractice suits is insane. If a doctor comes in to work drunk and mistakenly amputates the wrong leg, I think the victim would sure as hell deserve more than $500k in compensation.

 

Nasor

i compleatly agree, they caped them here as well and my first thought was that it was the stupidist move ever. What they needed to do was fix the LEGAL system not cap genuine remuniration if doctors were unfairly being forced to pay out

 

You're comparing the practice of medicine with flying plane?!

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I was comparing it to a six sigma operation..airline safety in The United States. Airline travel in The United States is of the Six Sigma standard...for the layman it rouglhly translates to zero defects. That is the standard that should be used in American Medicine and if American Medicine were at that standard, medical malpractice claims would be even less than they are today.

 

Roman,

I'm not 100% but my feeling is supply and demand. The AMA has lobbied hard for congress to restrict opening new med schools. This makes everyone, but the consumer, happy.

Think about Japan. Highest ratio of doctors to public in the world. Mush better tech than in the USA. We'll say "ultra" tech. Very cheap price and great care.

So, I think we just need more medschools and more docs and then we'll have a better price and better quality. Also, I'd like to see online rating like Amazon.com for each doc.

Michael

 

Very well said Michael! Not only have the physicians done a great job of restricting competition and errecting barriers to entry, the pharma companies have done a great job as well.

The solution to the healthcare crisis is going to have to address the issue of healthcare cost, and to do that it is going to have to look at the whole industry. Things are going to have to change either by freeing up the market place or by government fiat...either way the current system is just not sustainable.