Should there be a requirement for doctors to see a minimum number of patients? A reader brought up this assertion regarding Michael Jackson's Personal Physician being paid $150,000 a month to be by his side 24 hours a day.
The commenter suggests that the physician has an obligation to see more patients because of the low "doctor-patient ratio" in this country.
Many people would argue the same about concierge service. Where physicians limit their practice to several hundred patients who pay fees to the doctor to provide unlimited access, quick appointments, home visits, internet visits and what ever else feeds their fancy. Concierge care is only possible by limiting the number of patients a physician must care for. There are only 24 hours in a day. If some patients wish to pay several thousand dollars a year for the right to have access to a physician they feel brings them an exceptional value, both patient and physician have every right to do so.
The unethical part of this debate is not that the physician feels a desire to make a living outside the constraints of third party medicine. But rather, the unethical part of this debate involves the low payment rates offered by your government and your insurance companies for providing a service that is worth more to people willing to pay it.
Physicians have every right to create contracts of care directly with the patient. And they have every right to charge what the market will bear. If that means fewer physicians for every one else, that is a direct result of the poor payment models being offered by third parties, not the unwillingness of physicians to sacrifice their well being to be others slaves.
The public has no right to tell anyone how much they should make. The market does. The government is not the market. As long as physicians accept government insurance or other third party insurances , they are saying the payment is adequate.
Not until physicians leave their status as pawns in the insurance market will any real reform happen in the patient-physician-insurance relationship.
There is a major reshuffling going on right now within the RVU system. Some specialties are being hit hard. As long as physicians accept the insurance, even with a 10% cut, they are saying that they are OK with the cuts.
It will take physicians walking out to force change. This is what primary care has done for the last two decades. They have walked out, possibly never to return.
If you want to blame a physician for only seeing one patient or for joining a concierge group, perhaps your anger is misguided. You should blame the third parties who decided the physician wasn't worth what they feel they could command.
You must also blame all nurses who retire early to take care of their kids. You must blame all nurses who choose to pursue non clinical work. You must blame all lawyers who pursue fields not related to public service.
No one has a right to claim another's sweat and tears as their own. If you think this physician has an ethical obligation to see more than one patient, you are free to pay him what he thinks he is worth to get his services.
Otherwise you believe in slavery.
