Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, August 22, 1993 TAG: 9308220071
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: Associated Press
DATELINE: LENGTH: Medium
Doctors have clearly broken ranks over money. Grousing about big bucks is reaching a crescendo among those who feel they don't make them. Internists and family practitioners, in particular, marvel and mutter over the lush paychecks of surgeons, radiologists, heart doctors and other specialists.
Until now, such talk has been little more than hospital gossip. But with attention refocused on President Clinton's efforts to reform health care, this could change.
Doctors' pay takes up 20 percent of the nation's runaway health bill. Since the U.S. public ultimately writes the paychecks, they might reasonably ask: How much does a urologist or pediatrician or pathologist really deserve to make? $100,000 a year? $300,000? $1 million?
Not surprisingly, some doctors say they are apprehensive about reform. It is unclear what it might mean for their earnings, but Hillary Rodham Clinton, who headed the president's task force on health care reform, has noted "the overwhelming public perception" that doctors charge too much.
All of this is especially galling to Koenig. She and her partner split $75,000 last year, all they cleared from their family practice in rural Exmore, Va., on the Eastern Shore. She has no retirement plan, she pays her own life insurance, and she has two kids in college.
"There's a major unfairness," she said. "Some cardiologists across the bay take home close to $1 million a year. I'm a specialist, too, and what I do is important. I feel slighted. Society doesn't think I'm worth as much."
Truitt, on the other hand, is satisfied with what he makes - "in the low 200s." But those million-dollar specialists bother him, too, even though some are partners in his 25-doctor internal medicine group in Palm Bay, Fla.
He and others complain that the work these specialists do is no harder than theirs. But Medicare and insurance companies traditionally pay more for surgery and for high-tech tests and procedures than for patient consultations to adjust blood pressure prescriptions, lecture them about weight control and generally figure out what ails them.
The two-tier system started evolving generations ago, when people paid their own medical bills and relatively low-priced charges for office visits became standard.
By the time high-tech treatments like angioplasties and coronary bypasses were developed and charges were set, insurance companies paid most of the bills and prices didn't matter to patients.
"They'll admit a monkey can do what they do," Truitt said of the high-paid specialists.
"These procedures are easy. They don't require much thought. And they get reimbursed $1,200 for a cath" - a heart test called cardiac catheterization - "that takes an hour. For an hour I spend with patients, I get paid $125, and it's probably more effort."
by CNB