Physician News

HHS proposes pay raise for Medicaid primary care

Debra Beaulieu — Wed, 16 May 2012 08:47:10 -0400

Primary care physicians who treat Medicaid patients may get a pay raise totaling $11 billion over two years under a proposed rule announced last week by the Department of Health & Human Services. The proposed rule would implement the Affordable Care Act's requirement that Medicaid reimburse family medicine, general internal medicine, pediatric medicine and related subspecialists at Medicare levels in calendar years 2013 and 2014, according to a statement from the Centers for Medicare & Medicaid Services. The federal government would pay the increase for primary care entirely with no matching payments required of states.

On average, Medicaid reimbursements amount to about two-thirds of Medicare payments for the same services. The HHS proposal would be a first step in closing this discrepancy, noted Healthcare Payer News. Roland Goertz, board chair of the American Academy of Family Physicians, told the publication that nearly two-thirds of AAFP's practicing members provide free and reduced-fee care to an average of eight patients a week. In many cases, he noted, patients wait to seek care until problems are serious when they could have been prevented in the first place with more prompt attention. Andy Allison, director of the Arkansas Medicaid program, added that the pay boost could help his state attract and retain more needed family physicians.

Although the proposed increase is temporary, the Associated Press noted a lobbying campaign to make the two-year raise permanent is likely if the law passes.

To learn more:
- read the statement from CMS
- read the post from Healthcare Payer News
- see the story from the Associated Press

Providers cheer proposal to phase out SGR

Alicia Caramenico — Wed, 16 May 2012 07:51:49 -0400

A proposed House bill would permanently repeal the sustainable growth rate (SGR) formula, preventing a 30 percent Medicare pay cut in 2013, and would phase out fee-for-service payments. The Medicare Physician Payment Innovation Act of 2012, proposed by Rep. Allyson Schwartz (D-Pa.) and Rep. Joe Heck, (R-Nev.), would use savings from the military pull-out from Iraq and Afghanistan to cover all costs, reported Medscape Medical News. According to the bill summary, payment rates would stay at 2012 levels for one year; then from 2014 to 2017, primary care, preventive and care-coordination services would get a 2.5 percent annual increase, while reimbursement for other services would rise 0.5 percent. – read the full article from FierceHealthFinance

Docs spend years defending malpractice claims

Debra Beaulieu — Wed, 16 May 2012 07:45:44 -0400

The latest research about medical malpractice cases against physicians reveals both good news and bad--but even the good isn't particularly rosy. According to a research letter published this month in the Archives of Internal Medicine, the vast majority (95.5 percent) of plaintiffs' claims never even reach a jury, with the court dismissing cases 54.1 percent of the time across specialties. Of those that do proceed to court, physicians prevail 79.6 percent of the time, Anupam Jena of Massachusetts General Hospital and colleagues reported.

But even with the likelihood of physician victory, all litigated cases come with steep costs of money and time. The researchers' analysis found that cases in which physicians won took 3.25 years to reach a verdict, and the process stretched even longer in cases in favor of the plaintiff. "The substantial portion of litigated claims that are not dismissed in court and the length of time required to resolve litigated claims more generally may help explain why malpractice claims undergoing litigation are an important source of concern to physicians," the researchers wrote.

In an effort to reduce the time and expense of malpractice litigation, as well as improve patient safety, a pilot program in Massachusetts is testing the University of Michigan's model of "disclose, apologize and offer" in addressing preventable adverse events. Under this alternative model, when unanticipated adverse outcomes occur, institutions, healthcare professionals and their insurers disclose that information to the patient and family, FierceHealthcare reported. They then investigate and explain why it happened and establish systems to improve patient safety and reporting. When appropriate, they apologize and offer fair financial compensation without the patient having to resort to legal action.

To learn more:
- see the article from Medpage Today
- read the story from Medscape Today
- access the research letter from the Archives of Internal Medicine

Surgery centers must keep keen eye on costs

Debra Beaulieu — Wed, 16 May 2012 06:48:47 -0400

For some physicians, opening their own surgery center is a dream come true. As orthopedic surgeon Michael Crovetti recently told the Las Vegas Review-Journal, having his own facility allows the doctor to control the environment where he provides surgery and rehabilitation and deliver what he feels is safer, more satisfying care.

However, especially in difficult economic times, these freedoms come at a price. Surgery volume is what keeps the center in business, Crovetti explained, calling times when the center is not in use a "big white elephant." The financial risk in being a part-owner of a center, therefore, can make it difficult to attract willing partners.

"We don't open the surgery center unless there's a reasonable amount of work," plastic surgeon Stephen Gordon added. "You need to have your accountant find out exactly what [kind of volume] is needed to become a viable entity."

Other struggles physician-owned surgery centers have encountered in recent years include difficulty hiring top quality nurses and other medical personnel amid shortages, and often finding health professionals that are available to be suffering symptoms of burnout. Meanwhile, some centers have found it necessary to cut back on staff to reduce expenses. To boost efficiency, Gordon has his scrub technicians cross-trained to do office work on nonsurgery days.

A recent article from Becker's ASC Review notes several other ways surgery centers can protect their profitability by reducing expenses. Strategies include site owners holding a "relationship meeting" with their banks to investigate opportunities to reduce fees, refinance or invest more wisely; implementing online registration to reduce nurses' workload; and hiring a top-notch purchasing agent who will be tuned in to price fluctuations among vendors for supplies.

To learn more:
- read the article from the Las Vegas Review-Journal
- see the story from Becker's ASC Review

State says docs sold patients on shady health credit card plans

Debra Beaulieu — Tue, 15 May 2012 15:06:27 -0400

Healthcare credit cards--which allow providers to be paid upfront, in full, for charges--are under scrutiny in New Jersey amid allegations that some providers have pushed the cards for their own gain. Potential violations of the state's consumer fraud law cited by NorthJersey.com include:

Pressuring vunerable patients to sign up for credit cards
Recommending more expensive treatments than necessary
Failing to complete the full treatment once the provider has been paid

The state Division of Consumer Affairs is investigating to examine how health providers are offering credit cards, following a recent case in which New Jersey dentist Mark Weber lost his license for abusing the cards. Among the dozens of allegations, prosecutors claimed that Weber proceeded to collect on a $6,000 loan from a patient for work that was never done. Weber also allegedly received thousands of dollars in double reimbursements by having patients take out loans for services that were already covered by their insurance. In court, the dentist's receptionists said that the lending company would send the practice gift certificates as rewards for signing patients up for credit cards.

Even without deliberate fraud taking place, it's not uncommon for patients to be caught off guard by interest rates of 24 percent or more or incorrectly believe that they're signing up for a payment plan with the practice rather than a line of credit with a third-party lender, according to the article.

As FiercePracticeManagement reported, following a similar investigation into health credit cards in New York, practices that do offer the cards should proceed with caution. While it's not the practices' responsibility to sit with patients and go over all of a card's terms and conditions, they should encourage their customers to read the information thoroughly before signing, Maria K. Todd, MHA, CEO of global health provider network Mercury Healthcare, said.

To learn more:
- read the article from NorthJersey.com

Related Articles:
Health credit cards: Proceed with caution
Physicians scrutinized over too many high-level codes
5 much better ways to collect patient debt

Uninsured have suffered over decade, foregoing doc visits

Debra Beaulieu — Wed, 09 May 2012 10:27:40 -0400

We already know that patients have been more judicious about accessing healthcare services over the past two to three years of economic turmoil in the United States. But a new study from Health Affairs confirms the trend goes back more than a decade. According to the authors, "access to healthcare and use of health services for adults ages 19-64--the primary targets of the Affordable Care Act--deteriorated between 2000 and 2010, particularly among those who were uninsured." Their research suggests, they say, that expanded healthcare coverage proposed under reform could indeed help turn the problem around.

In 2010, according to the survey, about 21 percent of respondents nationwide said they had an unmet healthcare need. Twenty percent said they hadn't been able to get into a doctor's office, while 39 percent hadn't been to the dentist. Among respondents without health insurance, a whopping 46 percent said they had an unmet medical need.

Compared to responses from a National Health Interview Survey in 2000, the number of individuals who didn't or couldn't access doctors went up over the decade. For groups that had access to public coverage, such as Medicaid and the Children's Health Insurance Program, however, healthcare access improved or stayed the same.

Access trends also vary dramatically by region, with Tennessee having more citizens than any other state that said they didn't go to the doctor because they couldn't afford it, timesnews.net reported. The state saw a 10.8 percent jump in unmet medical need from 2000 to 2010, a trend Gordon Bonnyman, executive director of Nashville's Tennessee Justice Center, said was directly linked to cuts in its TennCare program.

"We went, in 2000, from having very broad coverage in TennCare in terms of eligibility and benefits to being one of the most restrictive states in the country in terms of eligibility and what we cover," Bonnyman told the newspaper.

Utah, in contrast, saw less dramatic changes during the same time period, the Daily Herald reported. There, unmet medical needs rose only 4.4 percent, versus 6 percentage points nationwide.

Steve Smoot, regional vice president for the urban south region of Intermountain Healthcare, attributed the slighter decline to a better public safety net. "Our system here in Utah County is the safety net for individuals," Smoot told the newspaper. "We have a very generous financial assistance; last year we gave out $24.5 million in assistance. Patients have to come to the hospital and if they meet our financial assistance requirements, they don't pay for that care."

To learn more:
- read the study from Health Affairs
- see the post from The Wall Street Journal
- read the story from timesnews.net
- read the article from the Daily Herald

Telemedicine's real threat to practices is better service

Debra Beaulieu — Wed, 09 May 2012 08:45:58 -0400

If retail health clinics represent a tough source of competition for traditional physician practices, online telemedicine providers may force offices to seriously step up their games in terms of convenience, cost transparency and service.

Despite the potential drawbacks of patients losing too much in-person contact with their doctors, employers, health plans and patients are being powerfully drawn to the benefits of timely, low-cost care for minor ailments, reported an article from USA Today and Kaiser Health News.

With the shared interest of keeping costs down, the likes of insurers United Healthcare, aetna and Cigna, as well as large employers such as General Electric and Delta Air Lines are pushing their members/employees to take advantage of virtual visits. Large companies, especially those that self-insure, are particularly enthusiastic about the ability to keep workers healthy with a minimum amount of time away from the job. Delta, for example, offers some employees access to Rite Aid's NowClinic for $10 a consultation (a 10-minute e-consult with a physician costs the public $45).

Some physician groups and consumer advocates, on the other hand, are apprehensive about the trend. "Getting medical advice over a computer or telephone is appropriate only when patients already know their doctors," Glen Stream, president of the American Academy of Family Physicians, told KHN. "Even for a minor illness, I think people are going to be shortchanged," he said.

But since nonphysician patients aren't generally equipped to assess the quality of the clinical care they receive, it's service differences that may catch their attention. For example, a patient who used NowClinic when she was uninsured told KHN that she'd use the service again even with insurance, in part because the online doctor called her three days after the e-visit to see how she was feeling. "I've never had my own primary care doctor do that," she said.

Forty-two percent of patients said they would consider changing doctors to take advantage of telemedicine services, according to telemedicine provider Smart House Calls based in Watkinsville.

To learn more:
- read the article from USA Today and Kaiser Health News

Demand, pay up for office-based nurses

Debra Beaulieu — Wed, 09 May 2012 08:35:01 -0400

In a tough reimbursement climate that's forced many practices to reduce or keep compensation flat for their employees, pay for nurses and nurse managers in the office setting has become more competitive, according to the Physicians Practice 2012 Staff Salary Survey. According to the recently released survey of 1,268 medical practices around the country, physician practice nurses received an average raise of 4 percent, while nurse managers commanded 12 percent more than in 2010.

The higher nurse wages are being driven in part by shortages in the profession, Susan Reese, chief nursing officer at Chelmsford, Mass.-based workforce management company Kronos, told Healthcare Finance News. "With dramatic nursing shortages on the horizon as large numbers of registered nurses retire or leave the workforce as the economy recovers, the pressure on all healthcare settings to attract and retain nurses will be great," she said. "Physician practices will need to increase salaries to compete for nursing resources, as well as make the positions more attractive by redesigning the roles and increasing the scope of practice."

In addition to the stiffer competition to attract and retain nurses, Christine Ricci, vice president of marketing for healthcare recruiting firm B.E. Smith, noted that while office-based nurses' salaries have expanded, so too have their responsibilities, such as providing more community-based care and duties in coordinating patients' care across multiple healthcare settings.

According to the Physicians Practice survey, pay for registered nurses ranged from more than $46,000 for 0 to 2 years experience to about $65,000 for 20 or more years of experience. Nurse managers earned about $55,000 in their first two years of practice and up to $75,000 once they reached the 20-year mark.

In a separate survey of 9,000 nurse practitioners and physician assistants, the Clinical Advisor pegged the average NP salary at almost $85,000 for five or fewer years of experience, while NPs with 20 or more years of experience made $88,000.

To learn more:
- see the Physicians Practice 2012 Staff Salary Survey slideshow
- read the article from Healthcare Finance News
- see the Clinical Advisor's 2012 Salary Survey

CMS delays Sunshine Act data collection

Debra Beaulieu — Tue, 08 May 2012 15:09:18 -0400

The Centers for Medicare & Medicaid Services is delaying a key part of the Physician Payments Sunshine Act (proposed in Dec. 2011), in which the agency won't start collecting data until 2013, CMS announced Thursday. "In order to provide time for organizations to prepare for data submission and to sufficiently address the important input we received during the rule-making process, CMS will not require data collection by applicable manufacturers and applicable group-purchasing organizations before January 1, 2013," CMS said in the blog post. --Read the full report from FierceHealthcare

Concierge model amplifies financial risks

Debra Beaulieu — Tue, 08 May 2012 06:17:45 -0400

When it comes to the growing prevalence of concierge and retainer-based medical practices, we mostly hear success stories. But the recent bankruptcy of a 10-year-old concierge practice in Florida serves as a reminder that the model is not immune to financial risk.

According to the Marco News, Naples Health Care Associates, which became the city's first concierge practice in 2002, filed Chapter 11 bankruptcy proceedings last month, showing assets of $32,222 and liabilities of $1,125,500.

The practice's troubles, however, stem not from a solo doctor shouldering too much risk, but from tensions and trust issues that can unravel any medical group. In this case, one of the doctors, Richard Kravis, seemed to be unhappy with the organization and influenced many of the practice's 500 patients not to renew their contracts and instead follow him to a new practice he planned to open on his own.

According to the company, it was the loss of these patients to a disloyal physician that contributed to the bankruptcy. The practice therefore is seeking a court injunction to stop Kravis from breaching a non-compete agreement included in his employment contract before he was terminated. The bankruptcy filing also notes that the practice is working to renegotiate leases and attract new capital to help save the business, the newspaper reported.

Despite the concierge model's potential to free doctors from the strains of relying on third-party reimbursement, being dependent on revenue from a small self-pay panel can make it more vulnerable to losing large percentages of income.

As FiercePracticeManagement reported previously, this scenario may not be as uncommon as it seems. As consultant Kathryn Moghadas, principal of Associated Healthcare Advisors in Winter Springs, Fla., had told Medscape about the retainer model, "Most of what I see is doctors failing at it."

To learn more:
- read the article from the Marco News

Embezzlement prevention: Checks and balances for everyone

Debra Beaulieu — Mon, 07 May 2012 09:42:13 -0400

No doctor wants to think that someone as trusted and integral to their practice as their office manager would steal from them, but stories of precisely that happen all too frequently. And it's not just petty cash, in any sense of the term, at stake. But it's hard to screen potential employees for trustworthiness, which is why checks and balances should always be in place to prevent fraud from occurring.

Recently in Mass., the family of 90-year podiatrist Irving Snyder discovered that his office manager had shopped and gambled away $1.2 million of the doctor's earnings, leaving them without even enough money for his funeral, the Boston Herald reported. The office manager, Gloria Balestracci, didn't just steal during the 13 years she was employed by the practice, either. The deception continued while she worked as the doctor's primary home and health aide after his retirement.

Balestracci's methods were not sophisticated. According to authorities, she simply forged Snyder's signature on checks to herself and to family members and made credit card payments from his account to credit cards in her name. When Snyder's family pressed her about suspicious activity, Balestracci told them the doctor was helping to pay for cancer treatments that she later admitted to never having. Balestracci was indicted in March on charges including larceny, forgery and making false tax returns, and is scheduled to be arraigned this week in Bristol Superior Court.

In another case, an Iowa obstetrician has, so far, unsuccessfully tried to hold his bank accountable for not catching the fraudulent check activity of his office manager, who he is accusing of forging checks over several years totaling more than a half of a million dollars ($547,996), the Des Moines Register reported.

The bank, which has refused the doctor's demand for reimbursement, now is defending itself in a lawsuit brought by the doctor. While court papers filed by the doctor accuse the bank of breach of contract, breach of fiduciary duty and being "negligent in honoring [forged] checks," the bank has held firm that "when authority is given to employees, it is the responsibility of the business owner to carefully monitor how that authority is used."

The office manager, who admitted she had a gambling problem, pleaded guilty to theft and forgery accusations in March.

Given that it's not uncommon for victims of embezzlement to discover too late that an employee has difficulties with money, it may be tempting for practices to check potential hires' credit upfront. But practices should take great care in making sure such a screening process is legal and transparent, American Medical News reported.

First, consider that federal law prohibits denying employment because of bankruptcy; at least seven states restrict the use of a credit report in hiring, according to the article. Next, practices should keep in mind that many trustworthy individuals have had their credit affected by the recent U.S. recession. Further, experts contend that there is no documented evidence to prove that a candidate with poor credit will be a greater threat to steal from the practice.

If practices decide to check potential hires' credit anyway, they need the candidate's permission to do so. If the employer withdraws a job offer because of credit history, federal law requires that the applicant receive a copy of the report and be allowed to respond to or rebut its contents. This discussion is critical to the practice, according to amnews, because it gives the employer the chance to consider any red flags in context and make an informed decision whether to make the hire.

To learn more:
- read the article from the Boston Herald
- read the story from SouthCoastToday.com
- see the story from the Des Moines Register
- read the article from American Medical News

New ideas combat employee turnover

Debra Beaulieu — Tue, 01 May 2012 17:46:57 -0400

One of the secrets to many successful practices' success is having a great staff. From front office to back, everything runs smoother when you have a team that's smart, motivated and loyal to your mission. Tampa-based Academic Alliance in Dermatology is one practice that understands the value of investing in its employees.

According to an article in the Tampa Bay Times about the 23-year-old practice, 90 percent of the five offices' combined 87 employees have been with the group for three years or longer, with the longest-working staffer working there for 18 years.

The group is generous with its perks--which include biannual continuing education retreats, thousands of dollars toward employees' professional development courses, free football tickets, half-price gym memberships, birthday lunches and more--but it also holds staff accountable to meet quotas for scheduling patients and selling dermatology products. Even with the goals in place, it's a noncompetitive work environment, physician owner Panos Vasiloudes told the newspaper. A key motivator: If just one employee exceeds his or her goal, everyone in the practice gets a bonus.

Not all practices, particularly small ones, can afford to offer these kinds of benefits, but a recent article from Inc. provides some strategies cutting-edge companies are using to retain top talent on a budget. Consider, for example, the idea of having staff award bonuses to one another based on who they see working hardest in the trenches. San Francisco-based online labor marketplace Coffee & Power uses this strategy by giving its 15 workers 1,200 stock options to award to colleagues. "It lets me reward people that management may not always recognize," said Becky Neil who works on the firm's marketing and product strategy.

Another innovative retention idea is that of a "lattice" advancement structure over a corporate ladder. In other words, employees would work with their managers to find flexible ways to "'dial up' or 'dial down' responsibilities, move to new roles, and otherwise create a work-life balance that made sense," the article explained.

To learn more:
- read the article from the Tampa Bay Times
- see the story from Inc.

Physician meditation, communication improve care

Debra Beaulieu — Tue, 01 May 2012 15:07:42 -0400

Learning "mindful meditation and communication" skills may sound to some doctors like a luxury for which they don't have time, but new research from the University of Rochester confirms it may be well worth the investment for physicians and their patients.

The study, published in Academic Medicine, is a follow-up to a paper the researchers published in the Journal of the American Medical Association in 2009. For the initial study, Howard Beckman, M.D., clinical professor of Medicine and Family Medicine at the University of Rochester Medical Center, and colleagues enrolled 70 physicians in a mindfulness training program that involved eight weekly sessions, followed by 10 monthly sessions. They found that participants were better equipped to handle psychological distress, fend off burnout and improve their well-being. For the follow-up, the team interviewed 20 of the physicians about their experience with the training.

Highlights from their feedback are as follows:

60 percent said the training helped them become more attentive listeners
50 percent said they were more self-aware and less judgmental in conversations at work and home
75 percent found strong benefits in being able to discuss their personal medical experiences with other doctors in the training program in a setting they felt was safe and free of judgment
70 percent placed a high value on the mindfulness course having a well-defined curriculum that designated time and space to pause and reflect

But to truly improve primary care, the researchers suggested training individual physicians in mindfulness doesn't go far enough.

"Programs focused on personal awareness and self-development are only part of the solution," the researchers stated. "Our healthcare delivery systems must implement systematic change at the practice level to create an environment that supports mindful practice, encourages transparent and clear communication among clinicians, staff, patients and families, and reduces professional isolation."

To learn more:
- read the post from the Huffington Post
- check out the press release from the University of Rochester Medical Center
- see the study abstract from Academic Medicine

Behind the numbers: Salary survey dishes up hot physician issues

Debra Beaulieu — Tue, 01 May 2012 15:00:04 -0400

Deb Beaulieu

Despite its narrow title, Medscape's Physician Compensation Report 2012 reveals much more than how much doctors are earning. In fact, the online survey of 24,216 physicians across 25 specialties provides up-to-date data on a number of hot issues discussed recently on FiercePracticeManagement.

For example, we've published numerous articles and commentaries during the past few months about physicians' responsibility to discuss the cost of care with patients.

And while we reported in 2010 that medical schools were beginning to incorporate cost awareness into future doctors' curriculum, it's been unclear to what extent current practicing physicians have approached this changing mindset. According to Medscape's survey conducted in February 2012, 38 percent of the physicians surveyed said they regularly discuss cost of care with patients. If the patient raises the subject, that figure rises to 46 percent. However, 16 percent of respondents reported that they never discuss treatment expenses with patients, either because they don't know how much services cost or they don't think it's appropriate to do so.

As the attention to healthcare pricing transparency intensifies, I'll be curious to watch how these numbers and attitudes change in the years to come.

Another very intriguing statistic from the report is that 67 percent of physicians said that, despite health reform's push to reduce "unnecessary care," they would not reduce the number of tests, procedures and treatments they perform in accordance with newer guidelines. However, another 27 percent said that they were behind the guidelines and thus planned to change their ways.

Note that these responses were collected more than a month before the ABIM Foundation and the American College of Physicians separately (though both in partnership with Consumer Reports) launched initiatives encouraging physicians to favor "high-value" care over many costly interventions that some experts say are too often performed needlessly.

It will be interesting to see whether Medscape's results are a predictor of how successful this push will be or if the specialty groups' recommendations will lead doctors to change their tune.

Less surprising, given the stories we've shared recently about physicians' financial struggles, is that very few physicians today say they "feel rich." As individuals inside the industry understand all too well, physicians' debts and expenses were generally so high that 89 percent overall said they did not feel rich--the part of the survey that grabbed headlines through mainstream media. While physicians may slow to recognize patients' financial burdens, the public is even further behind in understanding those of their doctors.

The survey covered several other trends in medical practice, such as how much time physicians spend with patients and which specialists said they would choose different career paths if they were to do it again. And of course, there's the data on how much physicians across 25 specialty areas earned in 2011. For more on these dollar amounts and trends, see the story in this issue of FiercePracticeManagement. - Deb (@PracticeMgt)

Half of docs think they're underpaid

Debra Beaulieu — Tue, 01 May 2012 14:56:55 -0400

The results are in from Medscape's 2012 Physician Compensation Survey of nearly 25,000 physicians across 25 specialty areas. According to the data, obtained by a third-party online survey collection site, respondents reported the following specialties earnings in 2011:

Pediatrics -- $156,000
Psychiatry -- $170,000
Obstetrics/Gynecology -- $220,000
General surgery -- $265,000
Plastic surgery -- $270,000
Cardiology -- $314,000
Orthopedics -- $315,000
Radiology -- $315,000

Although physician income declined in general compared to Medscape's 2011 survey, ophthalmologists gained a 9 percent pay increase, followed by a 5 percent bump for pediatricians and 4 percent increase for both rheumatologists and oncologists. Hardest hit with decreases were general surgery with a 12 percent decline, followed by orthopedic surgery and radiology down 10 percent and emergency medicine down 8 percent.

The survey also measured several physician attitudes. In particular, the survey found that physicians are split almost evenly in whether they're compensated fairly, with 51 percent of all physicians and 56 percent of primary care physicians reporting their income was fair for the work they perform.

On a similar controversial note, a mere 11 percent of the doctors surveyed said they considered themselves rich, mostly because of heavy debt burdens and/or the expenses of running a medical practice. If they had it all to do again, more than half (54 percent) said they'd still choose medicine as a career, 41 percent said they'd choose the same specialty and 23 percent would choose the same practice setting.

While acknowledging that physicians are among some of the highest-paid professionals in the United States (and disclosing that he has no compensation complaints of his own), plastic surgeon Anthony Youn addressed the public's assumptions on physician pay in a post on CNN's The Chart blog. "NBA players average $5.15 million per year. Just for putting a ball in a hoop," he writes. "When you consider these numbers, the thought of pediatricians making $156,000 a year doesn't seem unreasonable."

To learn more:
- check out Medscape's Physician Compensation Report 2012
- see the story from msnbc.com and Kaiser Health News
- read the post from CNN