28 July 2012

Salaries, Healthcare Inflation, etc

Andrew Sullivan draws attention to an essay by Eli Lehrer. Sullivan quotes the opening paragraphs, but this one caught my eye:-
Not only are the wages high but medical jobs have the kind of security few other professions can match. Total employment in the medical/education “super-sector” has never declined in the more than 40 years that the Bureau of Labor Statistics has tracked it, using current methodologies. Between 2008 and 2010, as the country sustained the deepest job losses since the Great Depression, the number of health care practitioners and support personnel increased by almost 400,000, even as the economy overall shed more than 7 million jobs. Doctors’ unemployment rate has never exceeded 2 percent. 
The implications of that passage are staggering. A related problem is the issue of confirming billing. How can patients confirm that their bills reflect services they a.) needed, b.) requested, and c.) actually received. My favorite medical billing trick is the referring physician asks a performing physician to interpret the result of some test. Why is the patient responsible for paying for this outsourced service, when they never meet the performing physician, cannot be sure that they actually required this outsourced  expertise, and may not have even been asked for permission for their medical records to be sent on to the performing physician. And, moreover, how can the patient know that the doctor actually performed this service? And, should a lawsuit for malpractice result, who should be named as the responsible party - the referring physician, the performing physician, or both? The patient and the insurance companies are cash cows in this arrangement.

But consider also what it implies about the general medical competence of the referring physician. The implications is that they are so under-skilled that they cannot interpret often basic radiological or laboratory findings without consulting specialized expertise. That cannot really be true, which leads invariably to the conclusion that the customers are being exploited.        

No comments:

Post a Comment