In your story about the compensation of doctors (“Wide pay gap persists among docs,” ModernHealthcare.com, Oct. 26), the researchers talked about the dollars per hour compensation of physicians of between $60 and $92. It would be interesting to look at hourly pay received by other professions or trades. Computer repair and service estimates are $50 to $75 an hour (with no government regulation and minimal overhead) and nurse anesthetists contract for $75-plus an hour (working under the supervision of a physician). Lawyers, accountants, architects routinely exceed over $150 an hour (with some overhead). Routinely, you pay more for experience and specialization in all areas of professional service delivery.
None of these professions or trades routinely enters into practice with over $150,000 in debt, has call obligations, major personal liability risk, clients without the means to pay, or federal or state regulatory exposure to the degree of a physician. And there is no adjustment in payment for most physician services for experience. A procedure is a procedure and an office visit is an office visit. Certainly this is the view of Medicare, Medicaid and major insurers.
The article points out that the evolving shortage in primary care may be the result of this pay disparity within the medical profession. The implied solution must be narrowing of this variation, and more equal hourly pay will improve this problem. I would submit that the real issue is that on an hourly professional rate of return standard, all services provided by physicians are undervalued, and it is not the differences between specialties that are the problem.
My point is that the distortion of the market by the “budget-neutral” Medicare view does not lead to a rational allocation of resources for a skilled workforce. Using an hourly rate reference point within the profession sets the profession against itself in a squabble over scarce resources and is the wrong reference point. I wonder in the context of what nonmedical providers get paid hourly for service-related activities if $90 an hour compensation for your ICU doctor, your obstetrician, or the oncology physician helping your family thorough the reality of dealing with a malignancy would be thought to be excessive. It might help explain the coming lack of access as intelligent individuals pursue other careers. R. Bruce Wellman CEO Carle Physician Group Urbana, Ill.