Specialist physician incomes, costs keep on rising

The compensation of specialist physicians has soared in recent years due to their increasing concentration on minor but often lucrative procedures that drive up healthcare costs, the New York Times reported.

The inflation adjusted incomes of dermatologists, gastroenterologists and oncologists rose at least 50 percent between 1995 and 2012, while incomes for primary care physicians rose only about 10 percent, according to the Times. That figure does not include additional fees that physician-owned ancillary businesses, such as laboratories or ambulatory surgery centers, may generate.

"It may be better to wait and see, but waiting doesn't make you money," Jean Mitchell, a professor of health economics at Georgetown University, told the Times. "It's 'let me do a little snip of tissue' and then they get professional, lab and facility fees. Each patient is like an ATM machine."

As a result, physician fees account for 20 percent of all healthcare costs, second only to hospitals, and continue to rise.

The use of Mohs surgery, a far more detailed dermatological procedure than merely freezing off a lesion, has increased four-fold in the U.S. in less than a decade, the Times reports.  Costs for the surgery can run more than $25,000. In one case costs were more than $14,000 for a plastic surgeon to close a small wound. The high charges persist despite the fact that there are still few definitive scientific studies demonstrating Mohs is more effective than simpler procedures, according to the Times.

While doctors in the U.S. earn about 30 percent more than their counterparts in other countries, they often vociferously object to any moves to reduce their compensation, particularly discussions connected to overuse of procedures. Specialists rely heavily on lobbyists in order to keep their levels of compensation for specific procedures in place, according to the Times.

To learn more:
- read the New York Times article

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