What doctors are truly worth

June 25, 2011

The author reflects on the possibility of being paid what you're worth.

Years ago, in the dying days of our relationship, my boyfriend remarked: "I think it's wrong you earn more money than I do."

Not a bright statement, under the circumstances.

Well, I've had it. No more rules I don't understand, co-pays that don't, refunds that won't, and paperwork that grows like Hercules versus the Hydra. I wish to propose new methods for physician pay.

PLAN ONE: BY THE HOUR, LIKE A LAWYER

The average lawyer, I'm told, bills $300 an hour and has no obligation to accept clients who won't pay in full, let alone not pay at all. He (or she) can bill for phone calls, paperwork, research, family conferences-all the things we do gratis. Hell, he can even bill for his secretary's time when someone calls to ask how much he bills. Now, we won't get into how a lawyer defines an hour-in 5-minute increments, or "billable time" I've been told (which could allow you, say if you're returning patient phone calls each averaging 3 minutes, to turn an hour into $500). Let's just do a straight $300 an hour.

My average day from the time I enter the first hospital to the time I get back into my car contemplating Taco Bell versus Burger King is 12 hours. Once a week I take night call, with an average of another 3 hours of emergencies, and I'm on every sixth weekend, for a grueling average 30 hours. (But this is after years of every third night and weekend, so hey, no big deal). As a lawyer can bill for research, those 5 or more hours a week I cruise the texts, read journals, or do continuing education become billable to someone. So an average 73 hours translates to $21,900 a week, or $1.095 million a year (assuming 2 weeks vacation). Even 40% overhead would leave me with $657,000 a year. Not shabby. I could pay off the mortgage, raise wages for my staff, and take extra vacation. Buy Fancy Feast for the cat.

Wait! Law school is only 3 years, without mandatory residency or a prerequisite "A" in organic chemistry. And, I'm a specialist, with 16 years of higher education and 22 years on the job experience. Why shouldn't I be worth $500 an hour? After all, that's what lawyers are willing to pay me to give a deposition. Just think of it. A mere $1.825 million a year before overhead. Almost up to a first-baseman's starting salary. I could live on that.