Issue link: https://viewer.e-digitaledition.com/i/442115
PHYSICIANS MAY BE SEEN AS THE BEDROCK OF THE HEALTHCARE INDUSTRY, BUT THEY ARE NOT ITS HIGHEST EARNERS, A RECENT ANALYSIS INDICATES. T HE INCREASING COST of medical care is a perennial subject of debate among patients, healthcare workers and policymakers alike, and some point fi ngers at high- earning physicians. "Doctor salaries are a pretty signifi cant part of the reason why the United States spends more per person on health care than any other developed country," Sarah Kliff wrote in 2014 on the news and opinion site Vox.com. Among other statistics, she cited a study fi nding that primary care physicians in the United States earn roughly double what their French counterparts earn. However, data analyzed by Compdata Surveys for The New York Times challenge some assumptions under- lying the healthcare cost blame game. Researchers report that hospital administrators and insurance executives often earn signifi cantly more than physicians. Some average salaries include: + $584,000 — insurance CEO + $386,000 — hospital CEO + $306,000 — surgeon + $237,000 — hospital administrator + $185,000 — general practitioner So what is driving rising costs and the disparity between the people running the medical business and the physicians providing care? According to Cathy Schoen, Senior Vice President for Policy, Research and Evaluation at the Commonwealth Fund, a foundation that addresses healthcare policy, the private insurance industry is largely responsible. Schoen suggests that simplifying the insurance industry may bring down healthcare costs by eliminating extra employees hospitals must hire to navigate the landscape of multiple carriers with multiple designs, deductibles, cost-sharing, and requirements for reporting and compliance. "All of that has led to proliferation," she says. "It's not just what the top person is paid, but the number of people that are working in a hospital and the number of people working in insurance companies that are working on paperwork rather than clinical care. There's just more of them. And … when you're in charge of more people, you tend to ask for higher pay." A Many-splendored Problem Two leaders with The Physicians Foundation, an organization that helps physicians navigate healthcare reform, see a variety of factors as more signifi cant cost-drivers than physician pay. In a column on Forbes.com, Physicians Foundation President Louis Goodman and CEO Timothy Norbeck say insurance costs do bear part of the responsibility — 85 percent of excess administrative overhead can be directly linked to insurance. But they also emphasize the high cost of treating chronic disease, as well as hospital costs, patients' poor lifestyle choices and, especially, the price of technology. "There is consensus among experts that tech- nology is the most important driver of healthcare spending costs over time," they write, noting the example of the $25,000-per-physician tab for implementing EHR. They add: "[E]xperts must look at all of these factors that are driving healthcare costs above the gross domestic product, population growth and infl ation — and recognize that the literature and data simply do not point to physicians as a primary or even secondary cause of rising healthcare costs." n Study Challenges Narrative of Fat-cat Physicians Driving Up Costs By Katy Mena-Berkley +++++++++++++++++++++++++++++ + +++ + +++ +++++++++++++++++++++++++++++ BUSINESS OF MEDICINE 2 6 | Long Island MD NEWS n M D N E W S . CO M