Sunday, August 14, 2016

Are Doctors Paid Too Much?

Years ago on Cape Cod, my kids and I stumbled across a man who had spent the day creating a sand sculpture of a mermaid.  It was an impressive piece of art.  “How long did it take you to make it? ” we asked.   While I can’t recall his precise words, the response was something like “25 years and 7 hours”.  I’m sure my astute readers will get his point.

We are transfixed now watching Olympic athletes performing in Rio.  So much depends upon their brief routines which can last seconds to a few minutes.  While a diver’s acrobatic plunge may take 2 seconds, it would not be fair to leave aside the years of work and training that prepared the athlete for this moment.

The same point can be made for anyone who has worked and trained hard to reach a point where the action performed seems easy to a spectator or a customer.   If an attorney prepares estate documents, we can assume that the fee for this reflects the prior training and research that the lawyer has done on this issue, as it should.  If an appliance repairman, by virtue of his expertise, fixed our ailing washing machine in 5 minutes and charged us $100, should we balk at this price gouging?  If a less skilled competitor spent 2 hours before finding and correcting the glitch, would we feel better about handing over $100?  Is this fair?  A musician doesn’t just wake up one morning and hop onto a stage to give a concert.  When we pay to listen to an artist perform for 2 hours, we are likely listening to the product of years of grinding work, disappointment, innovation and discovery.

What's a fair price for an hour of Aretha?

I believe that this same principle applies to my own profession.  Over the years I have heard patients complain about various medical charges and fees. While we all know that there have been excesses, many of their gripes are misplaced, in my view.   It’s not fair to equate the medical fee with the time that the physician expended on providing your care.  A cardiac bypass operation takes just a few hours.  A colonoscopy takes 10 minutes.   Treating a patient in an emergency room with a drug overdose may take just a few hours.  A psychiatrist might guide a suicidal patient to choose another path in half an hour.  A spine injection to relieve chronic pain takes only a few minutes.  A dermatologist recognizes a suspicious lesion in a few seconds.  A seasoned surgeon tells an anxious patient after a 20 minute consultation that surgery is not necessary.

Often, folks who make is all look easy are fooling us.  If we think it’s as easy as it looks, then we’re the fools. 


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