Scrambled Egg Medicine

We were talking a bit at dinner tonight about an article in the Washington Post which said that certain doctors are now charging on-going fees in addition to their normal schedule of fees. The article called this 'caviar medicine', which is a bit of a misnomer. Later in the article, it spoke of doctors charging large fees, on the order of hundreds or thousands of dollars, per year, in addition to the normal fees. That's caviar medicine. Call this.... scrambled egg medicine.

For some time, I have thought that doctors earned too much money. I find it difficult to think that what a family practice doctor normally does can be worth the going rate, which around here is about one hundred fifty thousand dollars a year. I don't know if that's before they pay malpractice premiums, and I don't know any doctors well enough to ask. I know one who might tell me, but probably wouldn't, as she tends to be fairly secretive about the business side of what she does. I know that doctors go through a lot to get where they are, and I know that their job can contain a lot of stress and scrutiny that I'd find intolerable. So perhaps one hundred fifty thousand a year isn't unreasonable.

Caviar medicine is a different story. The point of high-additional-fee medicine, as I see it, is to practice medicine the way that the practitioner wants, while maintaining or perhaps increasing income. Its that last clause that usually gets me. I think it smacks of gouging, even if it is only gouging those who 'choose' to be gouged. When your alternative is hunting for another doctor, it might not be much of a choice. But the scrambled egg medicine people aren't doing it to be able to work thirty hour weeks while still jetting to St. Barts or Chiang Mei for the casual vacation. According to the article, the doctors who are tacking on additional fees, of anywhere from twenty dollars a year to a couple of hundred dollars a year, are doing it in an attempt to replace the income that they've lost from declining insurance payouts, and to compensate for additional costs they've encountered in taking time to fill out forms, answer phoned-in questions, and having staff just to deal with insurance companies and maintain HIPAA-compliant records. I think that's reasonable. Good docs are worth saving. I'd pay that fee, if asked.

No, I'm not volunteering.