Most of us regularly read articles or hear newscasts that boldly claim that physicians are overpaid. After all, who among us hasn’t received a terrifyingly large bill after a medical procedure? Surely Orthopedic Doctors and Surgeons must be living the high life, with healthcare spending being so out of control?
On a per capita basis, health spending in the United States has increased over 31-fold in the last four decades, from $353 per person in 1970 to $11,582 in 2019. In constant 2019 dollars, the increase was about 6-fold, from $1,848 In 1970 to $11,582 in 2019. That’s PER PERSON. And we don’t yet have the full picture of what COVID has done to individual healthcare costs – especially considering how one week in the ICU can cost far upwards of a million dollars.
Where is all this money going?
Contrary to popular belief, the lion’s share of healthcare spending does not go toward doctor pay.
At 20 percent, physician pay is not an insubstantial piece of the healthcare spending pie. On the other hand, in terms of cost increases, a far greater portion can be ascribed to the rapid rise in healthcare administrators. In 2017, Becker’s Hospital Review reported that while the number of practicing physicians increased by 150 percent from 1975 to 2010, the number of administrators increased by 3,200 percent. This year, Modern Healthcare reported that compensation for CEOs of the 25 largest not-for-profit healthcare systems increased by a mean 33.2 percent in 2017 alone.
Generally speaking, increases in physician reimbursement have failed to keep up with inflation or overhead. Insurance companies are, without fail and across the board, expecting us to do more, with fewer resources and for less pay than ever before.
Some insurance companies, such as Caresource and Blue Cross Blue Shield, will force a ‘race to the bottom’ among clinics, and only support clinics as ‘within network’ when they agree to absolute rock-bottom prices that do not actually generate a profit for the facility.
Caresource, for example, remunerates us, Dayton Orthopedic Surgery, with $260 for a knee scope, which barely covers the provider salary, facility fees and administration fees per patient. Orthopedic clinics certainly aren’t heading to Aruba on knee scopes, even though they can then turn around and charge you thousands of dollars.
The cost of Orthopedic Diagnoses and treatment
When compared to other surgical specialties like Dermatology or Plastic Surgery, the cost of achieving an orthopedic diagnosis is far, far higher. Other types of surgeon will almost never refer you for an MRI or comprehensive x-ray series, yet Orthopedic Surgeons need advanced (and expensive) diagnostic imagery to perform our jobs to the best of our abilities.
Very few surgical specialties will require extensive follow-up appointments, physical therapy, supportive care, occupational therapy, advanced casting or mobility aids, etc. In Orthopedic Surgery, it is the other way around: very few orthopedic patients will be able to return to an excellent, relatively pain-free quality of life without extensive and ongoing support from our highly-trained specialists. At the very least, some kind of physical therapy is usually required after an orthopedic surgery, which will certainly add to the sticker shock when you receive your bill.
Consider the level of education and risk required to practice Orthopedic Surgery
Orthopedic Surgeons spend 4 years in college getting their undergraduate degree, before applying to Medical school. From there, they spend a further 4 years in Medical school, before graduating to 5 years in Residency. Then possibly 1 year as an intern under a practicing Orthopedic surgeon, followed by another 1 to 2 years of an Orthopedic fellowship.
That’s 16 years of grueling, high-pressure higher education, all before you’re allowed to actually earn money as an orthopedic surgeon. 70% of orthopedic surgeons enter the field with over $200,000 in debt.
Getting an unpleasantly large medical bill can impact your life in so many negative ways, and we understand the urge to look around for someone to point a finger towards. We hope that you will consider the points we have made here before doing so, and remember that as Dayton’s leading independent Orthopedic clinic, we fight every day against pencil pushers and penny pinchers at insurance companies, to get you the best treatment possible, at the lowest reasonable cost.