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MEDICARE IN USA: DOCTORS NOT ALLOWED TO CARE ABOUT MONEY (PART 1)

Patients generally place a lot of trust in their doctors and want to believe that this benevolent authority figure cares deeply about their welfare and nothing else. Believing otherwise could be very distressing.


Why Aren't Doctors Allowed to Care About Money?( PART 1 )

By Leslie Kane/Medscape


A number of consumer websites are taking polls that ask the public how they feel about the healthcare reform bill. Most response was positive, although some consumers expressed surprise that not all doctors are happy about the healthcare reform plan.

Their premise is: given the societal benefit of having millions more Americans with insurance coverage, some doctors should be putting income concerns aside.

Obviously most patients know very little about the details of physician reimbursement problems. They can't sympathize with something they don't know about, and probably wouldn't sympathize even if they did.

This isn't a new issue, and doctors know better than anyone that there's not a ton of sympathy out there for declining physician incomes. And even though it's mostly all about income-envy, there are a couple of reasons why people feel doctors should not be concerned about income at this time:

They say: Doctors still make enough.

This is a 'duh.' People seem to have an internal barometer of how much money they think is enough for someone else to make. Anything beyond that is unnecessary.

So, if a worker makes $50,000 and is supporting a family of four, he doesn't think doctors need to make more than, say $90,000 (maybe $120,000 for top cardiac surgeons). His thought is, "Doctors make more than I do, so they should be happy with what they have."

Consumers barely know or care about physicians' student loans, malpractice premiums, extra years spent in medical school, or remuneration for taking on life and death responsibility for patients' health.

People in helping professions aren't supposed to care about money.

This is a very pleasant myth.

The world is much less complicated when you dichotomize things into black and white. If you're in a helping profession, you--like Mother Teresa--should care only about others and not about yourself.

Patients see their doctors as good people, and find it jarring to realize that this good person could place financial self-interest (or even the desire to cover office overhead!) equal to or perhaps ahead of helping others.

The Caring Authority Figure

Even with today's trend toward a patient/physician partnership, a doctor is still an authority figure who dispenses life-changing treatment and advice.

Patients generally place a lot of trust in their doctors and want to believe that this benevolent authority figure cares deeply about their welfare and nothing else. Believing otherwise could be very distressing.

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Of course, I'd be remiss in not pointing out that there are many consumers who fully support doctors' financial concerns. I've heard patients say, in effect, 'for what doctors do and what they put up with, they should not get a raw deal.'

Amen to that.


Leslie Kane

Leslie Kane is Editorial Director of Medscape's Business of Medicine site. She is the former editor-in-chief of Medical Economics magazine. Ms. Kane is on the Board of Trustees of Valley Hospital in Ridgewood, NJ. She has also been named as a Population Health Associate (non-faculty affiliate) with the Jefferson School of Population Health at Thomas Jefferson University. She has a master's degree in counseling. Ms. Kane has held corporate positions in marketing, business reengineering, and advertising.

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