Saturday, August 23, 2014

Doctors get paid too little

The general perception in society seems to be that doctors charge too much . They are seen to be greedy; loaded with money ; drive around in a Mercedes ; and play golf on weekends. They are perceived as being crooked because they make a lot of money on the side by : cheating health insurers by padding hospital bills; taking kickbacks from pharmaceutical companies for prescribing their brands; and from diagnostic centers for referring patients for expensive scans and tests which are unnecessary .

Ironically, people don't mind splurging money on luxuries ( such as going to dinner at a 5-star hotel or going for a holiday abroad), because they value the experience this provides them. However, they grudge having to spend money on their medical care. They feel this is money which was wasted , because all the doctor does is get you back to normal – it doesn’t leave you any better off than you were ! This is why going to a doctor is seen as a wasteful expense, rather than as a positive investment in your health.

When you are ill, you are willing to pay the doctor whatever he wants. When you recover, then you grudge him his fees !

This reminds me of the joke of the businessman and the doctor.

When the wealthy businessman choked on a fish bone at a restaurant, he was fortunate that a doctor was seated at a nearby table.

Springing up, the doctor skillfully removed the bone and saved his life.

As soon as the fellow had calmed himself and could talk again, he thanked the surgeon enthusiastically and offered to pay him for his services.

"Just name the fee," he croaked gratefully.

"Okay," replied the doctor. "How about half of what you'd have offered when the bone was still stuck in your throat?"

Be that as it may, how much should a doctor charge ?

This is a difficult question to answer, so let’s look at what our wise judiciary has to say about how much a human life is worth.

If a doctor is negligent, and a patient dies as a result of this, the court is willing to award damages in crores of rupees. Using the same yardstick, then the doctor saves the patient’s life, then why shouldn’t he charge 0.1% of the value of the life saved ? I am sure most doctors would be very happy with this !

We need to be consistent, and it’s unfair to pay doctors so little when they do their job well; and to then punish them so severely when they don’t !  Pediatricians would easily become the richest specialists, because of the number of quality life-years they add to a child’s life.

1 comment:

  1. Anonymous2:45 PM

    Dr. E. Pellegrino’s Precepts as a Suggested Replacement for the Hippocratic Oath (Pellegrino & Thomasma, 1988):

    1) “To place the good of the patient at the center of my professional practice and, when the gravity of the situation demands, above my own self interest.

    2)  To possess and maintain the competence in knowledge and skill I profess to have.

    3)  To recognize the limitations of my competence and to call upon my colleagues in all the health professions whenever my patient’s needs require.

    4)  To respect the values and beliefs of my colleagues in the other health professions and to recognize their moral accountability as individuals

    5)  To care for all who need my help with equal concern and dedication independent of their ability to pay.

    6)  To act primarily in behalf of my patient’s best interests, and not primarily to advance social, political, or fiscal policy, or my own interests.

    7)  To respect my patient’s moral right to participate in the decisions that affect him or her, by explaining clearly, fairly, and in language understood by the patient the nature of his or her illness, together with the benefits and dangers of the treatments  propose to use.

    8)  To assist my patients to make choices that coincide with their values or beliefs, without coercion, deception, or duplicity.

    9) To hold in confidence what I hear, learn, and see as a necessary part of my care of the patient, except when there is clear, serious, and immediate danger of harms to others.

    10)  As always, even if I cannot cure, and when death is inevitable, to assist my patient to die according to his or her life plan.

    11)  Never to participate in direct, active, conscious killing of a patient, even for the reasons of mercy, of at the request of the state, or for any other reason.

    12) To fulfill my obligation to society to participate in public policy decisions affecting the nation’s health by providing leadership, as well as expert and objective testimony.

    13) To practice what I preach, teach, and believe and, thus, to embody the foregoing principles in my professional life”

    How many doctors follow this today ? If you are all paid high ( define please ! ) will you people follow this ?


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