Monday, May 3, 2010

Why Can't A Doctor Be More Like A Lawyer?

Two recent articles in the New York Times show an interesting contrast in the livelihood of doctors and lawyers.  The first article talked about a study in the New England Journal of Medicine that detailed the "invisible" work of primary care doctors.

Family doctors are paid mainly for each visit by patients to their offices, typically about $70 a visit. In the practice in Philadelphia covered by the study, each full-time doctor had an average of 18 patient visits a day. 

But each doctor also made 24 telephone calls a day to patients, specialists and others. And every day, each doctor wrote 12 drug prescriptions, read 20 laboratory reports, examined 14 consultation reports from specialists, reviewed 11 X-ray and other imaging reports, and wrote and sent 17 e-mail messages interpreting test results, consulting with other doctors or advising patients.
The second article talks about the billing practices of attorneys involved with the recent bankruptcy cases of America's iconic corporations like Lehman Brothers and General Motors.

THINK the lawyers are expensive? Meet the consultants. Alvarez & Marsal, a turnaround firm that is essentially running what remains of Lehman, has billed more than $262.1 million.

No charges have been too big, or too small. The Huron Consulting Group, a management consultancy involved in Lehman, charged $2.54 for “gum in airport.” In the G.M. case, Brownfield Partners has billed $230,209.55, including an $18 fitness-club charge at a hotel.

 The doctor has gone through four years of medical school, three to four years of residency slaving away at subminimal wage, incurred hundreds of thousands of dollars in debts, only to work in an environment where requests for reimbursement is denied or downgraded and much of the work isn't even billable.  In the meantime lawyers can charge their clients for chewing gum and pretty much make up whatever hours they please as "research" into their clients' cases with little oversight.  This country's priorities are so screwed up that we willingly accept these lawyers fees for complicated paper shuffling that the same profession has set up while the task of saving lives is nickeled and dimed until less than ten percent of medical students want to go into primary care.

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