I had a funny experience yesterday in the office. A very happy patient returned to see me three months after her arthroscopic rotator cuff repair. She was feeling great. She had no pain, normal function, and was back to doing all her activities.
She presented me with a jar of honey from her farm, and said, "I saw your bills from Medicare. I can't believe that's all you get paid for these surgeries. I wanted to give you something extra!" We shared a laugh and I am now the proud owner of a fresh pound of honey.
The point of this is not to say that doctors don't make enough money. We do just fine, and are blessed to be in this profession. The real point is that physician fees make up a very small portion of health care expenditures. For instance, surgeon reimbursement for a medicare rotator cuff repair is roughly $1,000. The amount we are paid for a shoulder replacement is in the neighborhood of $1,500. On the other hand the total cost of a shoulder replacement surgery is $10,351 according to a study out of Johns Hopkins. Based on this math, 90% of the cost is not your surgeons fee. Does that seem right?
As health care costs continue to spiral out of control the American public should understand where these costs are coming from: hospital charges, device manufacturers, insurance companies. Of course, these entities have powerful lobbyist, who ensure that money continues to flow to these industries. As a result, it is easy for politicians to cut reimbursement to physicians instead of tackling the real problems.
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