Can't doctors care for their money?

I have not ear marked my blog to doctors only and therefore this blog may not create the same response in everyone reading it. Anyway as a doctor and that too an anaesthetist whose names will not figure in payroll of most of the hospitals I think its hightime to share my view. I had received e mail update from medscape.com,-"Why Aren't Doctors Allowed to Care About Money? Part 2"by Leslie Kane- a few days back. It was a blog on the new health policy of USA and how it affects the payment of doctors. Many of the doctors had said their views.Here I like to mention some of them.

An anesthesiologist commented, "My plumber with no student loans, no education, and accepting only cash payments has an easier and more profitable career. Yes, medicine is a very altruistic career, but altruism doesn't pay for college, graduate schools, mortgages, food, etc..



Another anesthesiologist said, "Doctors are allowed to care about money, as long as no one's life depends on the service they provide. No one is proposing that plastic surgeons be required to provide a certain level of free care. That's the paradox -- the more life critical one's specialty is, the less they are afforded the opportunity to care about what they make."

"What really concerns me amongst people who are critics of physician salaries is the notion that physicians shouldn't care about their incomes," said a general surgeon. "This is a disrespectful and ignorant point of view that serves only to dissuade capable individuals from choosing a career as a physician in the first place."

An emergency medicine physician said, "The two bases of human emotions are envy and greed. Joe Average is envious of physicians' status and earning ability, although he knows he was not smart enough to get the required training or disciplined enough to complete it. The latter emotion, greed, is simpler: He wants everything for free...We can't overcome these basic instincts.

An endocrinologist asked, "For all these patients who think that doctors make too much money, I would like some answers. Why is it okay for the entertainment world (athletes, movie stars, television personalities) to be millionaires? Is it not okay that your doctor who had to endure twelve or more years in medical school and residency be compensated for this?

One family physician summarizes the irony of actually being an altruistic doctor: "It seems I help treat the needy and we see patients milking the system. We are in danger of being sued by the 'cannot make happy group.'
It surprised me that as most of us, doctors in India, think that USA is paradise for doctors and when we go there we will become millionaires. But I am sure that not only in USA but in any country the payment to doctors is very less when compared their service. The other side is always green, isn't it? When such a question is asked to our doctors I am sure the answers will be the same. May be the payment system in USA is different from our country. There,patient is not directly paying to the treating doctor but to the insurance company. The doctors there left the ordeal of collecting money to the insurance people for many years and are now feeling for it.
In the above said article one doctor had said,"Doctors have allowed the insurance companies and other payers to substitute for their own collection efforts," said an emergency medicine physician. "Because of this, they have become even more uncomfortable with receiving payment in any other way. We have suckered in for 'the only ethical way to receive money is if others just GIVE it to us.' We didn't take responsibility for our own incomes and that is why we are here. It was just easier to let 'the big daddy' do it -- albeit with huge pressure from 'the big daddy.'"


But here the story is differnt but effect is the same. Can you tell with confidence that you get what you think is your reasonable professional fee from your patients? How many doctors get their money without bargain? Is there a uniform fee system here? People are ready to spend on things that make them happy or they think they are happy when they are doing such things. A common man can shell out Rs 200 to buy a movie ticket but he thinks its a waste if he give Rs 50 to his doctor. After all these tiring years of medical college, residency, PG preparation time, toiling PG period and loans to set up a small practice place, you have work till midnight to get that Rs 50. A teashop owner earns on an average Rs 1.5 lakh per month believe it or not. He sells coffee worth just a rupee for Rs 6. Just imagine what we are doing? What is the electrician bill per day - Rs 300! That if you call him two days earlier, if its a emergency it escalates.But even if you are called at midnight you can't charge it high yet there is a provision to do so. Because you are a doctor and you are there to treat a patient in need but your needs won't be met. I don't think it makes sense. I agree this is a service but can't I be allowed to ask my fee which I think reasonable. Of course I am not demanding it before my service. Is it not like cheating? Why people pelt stones at a hospital alleging demand of excess fee? Is there a code to collect same money at all hospitals? Why people keep mum at hotels charging excess bills , way high for what they provide? Why people throng theatres even if ticket fee is Rs 200? Why lawyers are not beaten up if they lose their case? Why it is not the same case with doctors? So we think that it is easy to get money from insurance company rather from our patient. People here including doctors are crying for insurance cover for mediacl treatment and the trend is slowly changing here too. But we have look at what happened in US when doctors handed over the 'collection responsibility' to insurance companies and I am sure insurance companies are same everywhere. Now they are chasing us but in few years we will be chasing them for our money.

An old Russian proverb:"The doctor is an angel when he tenders his cure and a devil when he tenders his bill."