March 20th, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Cardiology, Finance, Hospitals, Neurosurgery, News, Radiology, Surgery, Urology
2 Comments »
I am opposed to millionaires, but it would be dangerous to offer me the position.
–Mark Twain
As we consider the wastefulness of the healthcare system, I have heard many people complain that physician salaries are one of the main culprits in escalating costs.
Dr. Reece compares the average income of some of the highest paid physician specialists, with that of hospital executives, medical insurance executives, and fortune 500 CEOs. Check this out:
Highest Paid Physicians
1. Orthopedic, spinal surgery, $554,000
2. Neurosurgery, $476,000
3. Heart surgeons, $470,000
4. Diagnostic radiology, Interventional, $424,000
5. Sports Medicine, surgery, $417,000
6. Orthopedic Surgery, $400,000
7. Radiology, non-interventional, $400,000
8. Cardiology, $363,000
9. Vascular surgery, $354,000
10. Urology, $349,000
Executive Pay for Massachusetts Hospital CEOs
1. James Mongan, MD, Partners Healthcare, $2.1 million
2. Elaine Ullian, Boston Medical Center, $1.4 million
3. John O’Brien, UMass Memorial Medical Center, $1.3 million
4. David Barrett, MD, Lahey Clinic, $1.3 million
5. Mark Tolosky, Baystate Health, $1.2 million
6. James Mandell, MD, Children’s Hospital, Boston, $1.1 million
7. Gary Gottlieb, Brigham and Women’s Hospital, $1 million
8. Peter Slavind, MD, Massachusetts General Hospital, $1 million
2005 Total Annual Compensation for Publicly Traded Managed Care CEOs
1. United Health Care $8.3 million
2. Wellpoint, Inc, $5.2 million
3. CIGNA, $4.7 million
4. Sierra Health, $3.4 million
5. Aetna, Inc, $3.3 million
6. Assurant, Inc, $2.3 million
7. Humana, $1.9 million
8. Health Net, $1.7 million
Top Corporate CEO Compensation
1. Capital One Financial, $249 million
2. Yahoo, $231 million
3. Cedant, $140 million
4. KB Home, $135 million
5. Lehman Brothers Holdings, $123 million
6. Occidental Petroleum,, $81 million
7. Oracle, $75 million
8. Symantec, $72 million
9. Caremark Rx, $70 million
10. Countrywide Financial, $69 million
But the real story here is the salary of our primary care physicians – those unsung heroes of the front lines. KevinMD pointed out a recent news article citing $75,000.00/year as the average salary of the family physician in the state of Connecticut, and that their malpractice insurance consumed $15,000.00 of that. Although this is certainly below the national average for pediatricians (they start at about 110,000 to 120,000), I’ve seen many academic positions in the $90,000 to 100,000 range.
Now I ask you, does it seem fair that the vast majority of physicians (the primary care physicians) are making one tenth of the average hospital executive salary? Should doctors really be in the cross hairs of cost containment?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 16th, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Family Medicine, Internal Medicine
5 Comments »
Richard Reece’s recent blog post echoes my sentiments – that it is important, in the midst of a broken healthcare system (and all the frustration that it creates), to stop and ponder the good things that yet exist. There are flowers popping up between the concrete slabs of our system…
Dr. Reece writes,
This is an anti-hero age. We no longer send bouquets or offer praise or optimism, beauty, life, or achievements.
Instead we doubt, dissect, disparage, analyze, impugn, question, and investigate.
Boy, do we investigate. We investigate Presidents, Vice-Presidents, Attorney Generals, Politicians, Army Generals, Priests, Physicians, and Establishment Institutions. The prevailing attitude is: if they or it have succeeded in our society, something must be wrong. Our most prominent heroes, even Mohammad Ali, have feet of Clay. So we send no flowers, only regrets that things are not perfect.
And physicians?
Well, they are the worst. Imagine. They err like other mortals. They occasionally misinterpret signs, symptoms, and results. They cannot guarantee perfect results under all circumstances. They cannot even repeal the Laws of Nature, or the inevitable Limits of Longevity. Physicians are not even omnipotent, omniscient, or omnipresent
…
Maybe we should praise our doctors and their institutions, considered many to be “the best in the world.” That may be why the U.S. introduces 80% of the world medical innovations and wins 80% of the world’s Nobel Laureates in Medicine even though we only have 5% of the world’s doctors. Maybe we should give our doctors flowers, instead of defoliating them. Maybe they should be our heroes, rather than our villains. American doctors are not miracle workers, but given limited resources and Nature’s limitations, they are damn good.
I encourage you to read Dr. Reece’s whole post. This excerpt doesn’t do it justice.
And if you’d like to give a shout out to a good doctor you know (in lieu of flowers) please comment here!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 3rd, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Food and Nutrition, News
3 Comments »
Well, twinkies are made of petroleum (among 38 other ingredients), and gasoline is also a type of petroleum product! This gives “food as fuel” a new meaning.
Dr. Charles, a young family physician, reviews the ingredients of twinkies in his recent blog post amusingly called “Reduce Twinkie Consumption and Dependence on Foreign Oil.”
This reminded me of the shock I felt when watching a documentary about America’s oldest citizens recently. I clearly remember them interviewing a man who was about 105 years old, who lived alone and used a golf cart to get around outdoors. The interviewer couldn’t resist asking the man why he thought he had lived so long in such good health.
The man said, “Well, I eat pretty good, get enough sleep, and I don’t worry about much.”
The interviewer then asked a probing question, “What do you eat?”
And I leaned in towards the TV screen, curious as could be.
And the elderly gentleman said, “Well, I eat a bowl of cornflakes for breakfast and then I usually eat a twinkie later on…”
Either the segment didn’t plan enough seconds for further investigation, or that was the sum total of his nutritional advice.
I was dumbfounded. For some people, it seems, good genes and good luck take them a long way.
But I’m still not going to eat petroleum products.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 1st, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Finance, Fraud, Medicare
No Comments »
Dr. Rob, the author of “Musings of a Distractible Mind,” is really good at explaining difficult concepts. If you haven’t read his description of healthcare’s coding system, you should take a peek. It explains why documenting care is so complicated, how doctors try to “game the system” and what happens to them if they do.
Here’s a small excerpt:
“You see, what you get paid for an office visit is not based on what you do at that visit, it is based on what you document. The more you can document, the higher you can bill… There are several responses to this situation by physicians:
· Undercode to avoid the accusation of fraud
· Use EMR to document more and bill at a more appropriate level
· Code at the higher level without documenting higher and risk audit, jail, etc.
· Stop accepting insurance and just accept cash up front based on your own criteria
· Do other things besides office visits – such as surgical procedures, labs, x-rays, or other procedures that pay much better than the office visit. The pay for EKG with interpretation is nearly as high as that of the decision making that the physician makes that may save the life of the patient.”
So next time your doctor is delayed in seeing you… she’s probably trying to document all the right check boxes and codes for the last patient she treated!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 18th, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Family Medicine, Internal Medicine, Psychiatry, Relationships
1 Comment »
An excellent blog post was forwarded to me for comment – an Internal Medicine physician reflects on his patients’ common underlying condition: isolationism.
Today I saw patients with the following problems:
- A person who had attempted suicide over the weekend
- A person who was possibly acutely suicidal and was abusing narcotics I was prescribing
- A person who is in an abusive relationship and has a severe eating disorder
- A terribly depressed woman in a dysfunctional marriage
- A pre-teen child whose father had suddenly died
My observation from today is that most of these people are isolated. They have difficult situations to face and the people who normally surround them are somewhat uncomfortable, not knowing what to say…
Western culture is obsessed with avoiding suffering. We entertain ourselves to avoid having to face the harsh realities of life. People die and suffer daily, and we are obsessed with the latest TV show, the latest political soapbox, or the latest self-help tool. We feel that the goal of society is to create happy and secure individuals. This is not true. The goal of society is to function as a unit in a healthy way – with the weak parts supported by the strong ones…
What I emphasized to the people I spoke with today was the need to find people who had gone through the same things. Those in the eye of the storm need to hear from people who have gotten to the other side that it is OK to feel the way they feel. Those who have gone through hard times have something huge to offer those who are going through them now – experience. You lose the pat answers when you have suffered yourself.
It is my hope that those who are struggling will find others online here at Revolution Health who can support them, and that those who have made it through to the other side will reach out to help others through our online community. Suffering is not meaningless if you harness it for good – your wounds can heal others.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
