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A prescription for disaster

I know I've groused occasionally about my personal finances, but this morning I noticed a story in the Boston Herald that gave me hope.

Dr. Henry Childs was a private-practice doctor in Massachusetts, and by all reports a good one. He recently retired after 30 years of private practice, and moved to Florida. And in his last year, he made about $50,000.

That's a smidgen more than double my gross pay for the same year. I'm making half of what a doctor in his 60's makes! I'm practically rich!

Seriously, the story just goes to show what Massachusetts is doing to itself. Dr. Childs doesn't give specific numbers, but cites property taxes, malpractice insurance, cuts in insurance payments, and rising home prices as factors. I've seen other accounts from other doctors who pay over a quarter of a million dollars a year simply to keep their office open, and end up taking home $50-60,000 per year.

These are DOCTORS, people. These are people who spent about a decade in training and education, racking up six figures of debts, and then spend decades building up their business, and end up making about as much as a retail store manager.

There's an old legend that when you see the rats leaving a ship, it's doomed. Not to cast any aspersions on the medical profession, but the same thing seems, to me, to hold for doctors and regions. Doctors should be among the last to leave an area -- they have a huge investment in staying where they are, through patients, peer relationships, hospitals, and other medical support mechanisms. And that's not even beginning to mention homes, country clubs, and the like.

When the doctors start fleeing your state, you KNOW you're in real trouble. But will Massachusetts see this, and realize just how bad a plight they're in?

I hope so, but I think not.

And more's the pity.



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Comments (19)

That's just wrong. I fully... (Below threshold)

That's just wrong. I fully expect doctors to make good money. I want them to make good money.

On top of things like malpractice insurance, on the other end they get squeezed by insurers who pay as little as possible and eagerly blame rising insurance costs on the doctors they're squeezing.

This is what auto insurers do to body shops, too. Rates go up and up and up, they pay shops so badly it's a wonder they can stay in business, and blame the rates going up and up and up on the body shops they are screwing.

Entry level doctors rarely ... (Below threshold)
Just Me:

Entry level doctors rarely make lots of money. It is the specialists that tend to make the money, but you would still think that a doctor should make more than 50-60k after decades in practice.

What do you mean start <... (Below threshold)

What do you mean start fleeing the state??

Doctors have been having problems here for 20 years! Med mal, for sure; HMO reimbursement rates shrinking, hospital contributions to the "Uncompensated Care Pool" (that's the fund that pays for all the free care to illegal aliens) ---

This was all a probkem when I was in the legisdlature in the mid-1980's. Nuthin's changed.

I agree with you about the ... (Below threshold)
Paul Zrimsek:

I agree with you about the larger issue, but still: when the sight of a retiree moving to Florida looks like an omen to you, it's time to take a step back.

Well, I see where you are c... (Below threshold)

Well, I see where you are coming from. I only disagree on one point. It isn't just MA. Part of the problem is bad doctors as well as the insurance companies.

Case in point.

1. How many of you heard about the Hospital in Tampa, FL (University Community Hospital, UCH for short) where they cut the wrong foot off of Rodney in 1994?

2. How many of you heard about the man killed by the respirator being turned off the following week?

3. How many of you heard about the spilling of 1/2 a unit of blood on the floor trying to hang it to an existing IV the month before?

4. How many of you heard about a botched eye surgery at the same hospital?

#1 and #2 made the national news. The only reason I know about #3 and #4? Well, I AM #3. #4 sits next to me at work. Both of us have standing orders with our normal doctors to not be let go back there under any circumstances.

Another case in point.

During my Cancer treatment, at one point the Doc sent me to the hospital. 3 days later surgery was done. They waited 3 days because 1. I was being filled with a drug which would make the surgery easier. 2. No surgery space was available and 3. I was being monitored round the clock, as they took me off 4 other drugs before surgery.

The surgery went perfectly (not UCH) and all the bills went to the insurance company, who promptly denied the 3 day hospital stay before surgery, because "nothing happened". The Doctor himself got on the phone with the insurance company and screamed at the clerk at the other end. They still denied the charges.

The doctor had his staff write off his billing for those three days, even though it was the insurance companies fault.

I had the last laugh though. Due to a major screwup by the insurance company, they were required by law to pay ALL the disputed charges for my case. Including the charges the doctor wrote off that day!

I haven't been able to set ... (Below threshold)

I haven't been able to set a trackback (maybe they're being screened for spam), but I did just post on this topic at my blog and wanted to let anyone interested know.

Here's the link

Thanks, enjoy

My wife and I just lost a s... (Below threshold)

My wife and I just lost a superb and very expereinced (30 years) OB/GYN doc up here in New Hampshire - similar reasons - he just couldn't continue the high costs of running a practice and the year on year pay-cuts. He's retiring early which is a loss for us and thousands of other patients. I recently had a doctor friend tell me that it's just not much fun anymore being a doc....when the fun's gone and the pay is gone and the demands (insurance, hmo's, ppo's) go up, I gotta believe the best and brightest will find other things to do...

I figure there are stats so... (Below threshold)
Just Me:

I figure there are stats somewhere, but I wonder how much states with lower costs of living and some type of malpractice reform bleed doctors incomparison to states that have high costs of livings and/or no malpractice reform.

Well Jay, I know lots of do... (Below threshold)

Well Jay, I know lots of doctors both in MA and here in NH who should be sued for malpractice.

It won't happen like you think it will. President Bush signed a bill recently cutting it down so this can't happen anymore to doctors and even those who deserve it. Maximum penalty suit $100,000 to go into effect now. Or did you miss that? This way here, he believes everyone can get medical care even if the person who's giving the medical care is no good. And this just wasn't happening in MASS, it was happening everywhere; it was part of his platform when he was running for his second term and about the first thing he did- protect the doctors from suits, putting a cap on the suits, which would bring their insurance way down to almost nil, making medical care available to all. Don't poke at MASS; he did it for the whole country.


Try living in Illinois, whi... (Below threshold)
Kevin P. Craver:

Try living in Illinois, which is almost surrounded by states that have caps on medical malpractice damage (in the Land of Lincoln, you can sue for however much you want). As of late 2004 (unless the situation has changed), Illinois does not have a single neurosurgeon in practice in the southern half of the state.

Doctors are fleeing left and right. Obstetricians are getting out of the business, seeing as how they are still liable for a child until he/she turns 18.

Doctors blame greedy trial lawyers (Illinois is home to the top frivolous lawsuit venue in the U.S., namely Madison County), greedy trial lawyers blame the insurance companies while being unable to explain away why this problem isn;t nearly as bad in surrounding states.

And the rest of us are wondering who the hell is going to deliver our children or put us back together in the event of an accident.

It's not just Mass., it's e... (Below threshold)

It's not just Mass., it's everywhere. Doctors are fleeing PA as fast as they can, but there's nowhere to go anymore.

Uhhh Cindy, yes we missed t... (Below threshold)

Uhhh Cindy, yes we missed that --- BECAUSE IT DIDN'T HAPPEN, you silly. All med mal reform efforts have failed over the past several years, due principally to the opposition of democrats.

Here's a very current review of exactly what has gone on, and is currently going on, in Congress at this time, from the National Conference of State Legislatures, which is the "progressive" association of state legislatures (as opposed to ALEC, whicc is the right-wing group).

I live in Boston. I lost a... (Below threshold)

I live in Boston. I lost a good doctor a few years ago because he was leaving his practice to go back into teaching. He couldn't afford to live on his doctor's salary.

While I'm loathe to attempt... (Below threshold)

While I'm loathe to attempt to bring factual reality into this comments thread...I'm going to try. It won't do any good....but here goes nothing.

Malpractice insurance premiums (with the exception of a few medical specialties) remain virtually the same state to state...even with those states that have malpractice award caps as a part of state law:


"with the exception of a fe... (Below threshold)
Just Me:

"with the exception of a few medical specialties"

Bingo, it is those exceptions that are often important. OB/GYN being one of them. A lot of family practice docs no longer deliver babies, because of the additional cost in premium.

(Reuters) Scientists from O... (Below threshold)

(Reuters) Scientists from Oxford and Brigham Young "Universities" announced their first significant finding today. Recovered from the Oxyrhynchus Papyri using advanced infra-red techniques, the fragments bore a striking resemblence to 1st century A.D. apocalyptic writings from the early Christian church, during the...

45. Then it would come to pass in the land of Massachusettes that consumer advocates, in league with the wicked barristers guild and the tyrant's taxmen, began pressing suit against doctors, in an effort to keep them from leaving the state

46. Then, to stem the surging tide of physicians fleeing the state and seeking political asylum in Florida, the residents of Massachusettes will build a Big Green Wall ("Creature?" "Behemoth?") to keep them in the lands of their fathers.

47. Honeyed-tongue government spokespersons will explain that "It's good for the community. We know better than you what's best for yout, comrade!" There will be a great gnashing of teeth as entire families of New Englanders will be split in two, when the Long Green Gash severs traditional IROC-Z migratory routes.

48. A giant thunderclap shall strike... and the assembled hosts of the world will shudder and gag at the colossal, cosmic irony of watching an out-of-breath and "ruddy" Ted Kennedy -- the Beast of Chappaquiddick -- clamber on to some Big Dig construction equipment to announce "Workers of the Bay State, Unite! Universal health care and clam chowdah for all! Ich bin ein Bostonian..."

49. Whereupon God will end the state's torment, bringing down much fire and brimstone on Beantown, retribution for its idolatrous worship of the False Prophet, Johnny Damon, and pronouncing the superheated plasma cloud to be "wicked-awesome".

As long as the voters in Ma... (Below threshold)

As long as the voters in Massachusetts think John (Hanoi lover) Kerry and the 'ole swimmer", are looking out for them, they can expect more of the same. High taxes, no accountability.

I left medicine in Michigan... (Below threshold)

I left medicine in Michigan in 1995 for similar reasons. There were years when 67% of my income after other costs went to Local, State and Federal Taxes. Then there were my insurance premiums and worker's comp premiums (part of that overhead already deducted...)

Malpractice suits are no way to stop medical errors. Only a way to make tort attorneys rich at the price of other's misfortune or perceived misfortune.

Medical Errors are a REAL problem and need to be addressed by a system that destigmatizes error reporting and actually addresses correcting the problems. Blaming a single person is rarely the solution to a problem with a system that does not have true safety and checks and balances built into it. If doctors had rest requirements, medical standards and strict drug and alcohol proscriptions that airline pilots have, you'd be hard pressed to find a doctor who would be legally working at any given time in this country. The kind of approach that the aviation industry took in the middle of the last century is what is needed now for the health services industry.

Just me- I was a sub-specia... (Below threshold)

Just me- I was a sub-specialist. My income tripled when I moved to Tennessee. Now a government worker, I am still above my average Michigan income in real dollars working Primary Care. I could have made more in MI, but it would have required selling my soul, which isn't for sale.






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