Dr. Andy

Reflections on medicine and biology among other things

Thursday, March 30, 2006

Doctors telling all

Should physicians reveal how they are paid? A new study suggests disclosing this information increases trust:
Disclosing how physicians are compensated may increase patient loyalty, and does not appear to undermine patients' trust in their doctors, a new study shows.

"This study suggests that regulators, policy makers, and physician groups themselves should renew their consideration of disclosure as an instrument to advance the best interests of patients and physicians," Dr. Steven D. Pearson of Harvard Medical School in Boston and colleagues conclude.
Sounds good, and I agree that patients should have access to the information.

An important caveat is that all the doctors in the study were paid by a combination of salary and bonus with the bonus based on a rather nebulous formula, so these doctors weren't conflicted in giving impartial advice. Patients who learned their surgeon derived 80% of income from operating might be less trusting of his or her advice to undergo an operation; of course, in the global scheme that is probably a good thing.


At 6:10 PM, Blogger Flea said...

The parents in my practice would die laughing.



At 7:59 PM, Blogger Dream Mom said...

I have no interest in learning how physician's are paid. It's certainly not that I don't care, because I do want them to be paid but it would get me thinking and perhaps undermining my trust in them or in physicians in general. I certainly would begin to second guess diagnosis-do I really need this or are they telling me this to increase revenues and perhaps bonuses?

I don't have enough knowledge about how the bonuses are structured but I guess the type of things I would begin to worry about in general would be insurance issues. Suppose, my son's insurance changes and the doc gets less reimbursement. Should I now be embarrassed to make an appointment because he won't get paid as much or because my son has a chronic illness and is labor intensive and the reimbursement is now less?

I have enough to worry about with these new high deductible medical plans and now I can add worrying about how and whether my doctor is paid.

I can tell you if I have to start worrying about that, I would be less likely to get any medical care for myself.

As a mother and caregiver, I am having a hard time understanding some of the changes in healthcare today. The absolute strongest link to any hospital is the physician. When you start messing with that system-like having us start worrying about how they are paid, or putting hospitalists in instead of our regular doctor, I begin to wonder who I should trust and if it really matters anymore where I get my care.

At 8:04 AM, Blogger ollie said...

Actually, I'd like to know.

Example: I went for my checkup (too long ago) and noticed that my doctor drove an expensive car. I thought: "he is probably successful; that is a good thing". :-)

One thing I've learned: NEVER brag about taking out your doctor's half-marathon PR prior to getting "The glove" =:-o

At 1:15 AM, Blogger Shazam! said...

Your doctor may drive an expensive car, but odds are that your retirement plan is better off than his. It's fairly well studied that the amount of time put into earning a degree, postgraduate training and establishing a practice is a huge disadvantage when it comes to a savings plan. Not only do physicians start earning late, they have huge educational debts, not to mention consumer debt like everyone else. Add to this trying to live up to the social expecations of being a doctor--wearing nice clothes/watch/shoes, golf clubs, belonging ot the right health or country club, living in the right neigborhood, driving the right car, sending the kids to private school. Doctors who live like this are really quite poor in terms of their overall net worth in spite of having material goods.

Most people earning a modest income right out of college who have been saving faithfully have a far larger net worth than most physicians ever will.

Sad (for them), but true.

Personally, I still wear ripped jeans, buy clothes on sale at Old Navy & Walmart, am a member of a community center (not a health club), and have no credit card debt. More than 30% of my income goes towards savings, counting my loans it's more like 40%...and that's just to get me back up to par with my peers who have been in the workign world for 10 years or longer.

Sure, in 10 years, I may be caught up, but I'll be plenty sick of medicine by then (I am already), and looking forward to a minimum wage, low stress job.


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