Many Physicians Take Actions To Increase Flat, Reduced Salaries, Study Finds
Many physicians in recent years have increased patient fees, treated more patients and offered more profitable services to raise "flat or falling" salaries, according to a study published in Health Affairs, the Boston Globe reports. At the same time, the study found that some physicians have offered fewer "traditional services that patients may need," the Globe reports. In the study, researchers at the Center for Studying Health System Change examined data from 12 U.S. health care markets and found that physician income decreased by 5% between 1995 and 1999 but increased "slightly" in 2000, the last year that researchers examined, the Globe reports. According to the study, some physicians have compensated for decreased income by "buying diagnostic equipment and offering patients tests" in their offices "instead of referring them to hospitals," the Globe reports. In addition, the study found that some physicians have opened ambulatory surgery centers, enrolled patients in clinical trials in exchange for fees from pharmaceutical companies and increased fees for some services. Some physicians also are "cutting back on poor-paying" services, such as treatment for patients enrolled in Medicare or Medicaid, the study found. The study concluded that such actions are "contributing to the public's rising use of medical services and to growing costs."
HSC President Paul Ginsburg said, "There's just a real increase in entrepreneurial activity on the part of physicians. Their feelings about their earnings may be a large part of it." He added, "There's an inherent conflict of interest in them prescribing their own services. There's some potential for over use." However, Dr. Thomas Sullivan, president of the Massachusetts Medical Society, said, "The financial pressures have been enormous. And they're getting worse because malpractice costs and office labor costs are going up. It's only reasonable that physicians try to make up lost income, as long as it's legal, has some benefit to patients and is safe" (Kowalczyk, Boston Globe, 3/9). An abstract of the study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.