Docs agree payment models need to change, but don't want less

A majority of doctors feel that something needs to be done to fix the ailing Medicare reimbursement situation, but very few of those doctors can agree on a remedy, according to the results of a survey published this week in the Archives of Internal Medicine. 

What's more, while a vast majority of those surveyed felt that generalists should be paid more, only 39 percent believed it would be OK to decrease payments to specialists to make it happen, despite a study concurrently published in AIM revealing that primary-care physicians earn as little as half of what their specialist colleagues take home. Data collected from 6,000 doctors between 2004 and 2005 revealed that primary-care physicians earned an average of just over $60 an hour, while surgeons took home roughly $92 an hour and pediatric and internal medicine doctors made $85 an hour, according to a Reuters report on the latter study. 

The authors of the second study point to the payment gaps as potential reasons for both the primary-care physician shortage plaguing the U.S., and rising health costs. They add that in other nations, specialty doctors aren't as prevalent as the primary-care counterparts. 

"That can be changed if we just change the salaries, and let medical students know about it so they don't pursue these specialties so aggressively," lead author Dr. J. Paul Leigh of the University of California Davis School of Medicine told Reuters. "Especially now that our costs for medical care are soaring, we need to get these disparities under control. And the government can. We don't have a free market of supply and demand operating for physicians, rather, it's highly regulated by Medicare." 

That conundrum, however, hinges on physicians' "willingness to make tradeoffs," write the authors of the Medicare reimbursement survey. 

To learn more:
- here's the AIM abstract for the survey
- and here's the abstract for the physician wage study
- read this Reuters article
- check out this MedPage Today piece

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