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QUICK POST: Hospital Savings: Salaries for Doctors, Not FeesJuly 27, 2009

Posted Nov 04 2009 10:08pm

There is a cadre of reformers that believe if only doctors where on salary then all would be well with health care economics.  Heath costs would be curtailed and our economy would be robust and without the drag of excessive health care costs. Yet, what they all seem to miss is that many of the doctors who work in these systems (Mayo, Cleveland, etc.) earn good salaries, but are the beneficiaries of tax payer largess.  How? By the extensive federal funding of medical eduction which allows these staff members to have fellows and residents take call, stay in the hospital, be the first responders for most medical and surgical emergencies.  These medical education based ‘indentured servants’ provide innumerable benefits for the doctors in these systems.  These perks allow these physicians to have a much more lavish and comfortable lifestyle than most physician in private practice.  Still, if the benefits are so great, then why are not the vast majority of physicians clamoring to work for or to create systems of the type hyped in this article. Why?  Because most physicians are ardently devoted to personal freedom and the ability to interact with patients in a way that is personal and unique to them.  They do not wish to be part of a cookie cutter, clinic system that treats all patients the same, usually as clinic numbers, and treats doctors as technologic commodities.  It is also true that many of these clinics are referral clinics, treating unique and complex cases and not doing much of the day to day health care that so many in both primary and speciality care do.  Forcing doctors on to salary would be among the most counter productive measures we could ever take in attempting to achieve real health reform.  Allowing doctors freedom to choose their style of practice has long been the key to the overall high quality of medicine practiced in the United States and can be  an asset as we work toward Real Health Reform  . . . obi jo and jomaxx

Changing those policies is crucial to the success of health care reform, economists say — something Mr. Obama said that he would do. “Our proposals would change incentives so that doctors and nurses finally are free to give patients the best care, not just the most expensive care,” the president said Thursday in Ohio.

Doctors in the United States are usually paid fees for each service they provide. The more procedures and tests they order, the more money they pocket. There is widespread agreement among health policy analysts that many of these procedures are unnecessary, raising costs in ways that often do nothing to improve patient health.

By contrast, Bassett — like the Cleveland Clinic and a small number of other health systems in this country — pays salaries to all of its doctors. No matter how many tests or procedures are performed, they take home the same amount of money. Medical costs at Bassett are lower than those at 90 percent of the hospitals in New York, while the quality of care ranks among the top 10 percent in the nation, surveys show.

Hospital Savings: Salaries for Doctors, Not Fees – http://www.nytimes.com/2009/07/25/health/policy/25doctors.html?ref=health

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