The Centers for Medicare and Medicaid Services released a massive amount of information today regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data. For everyone else, here is a simple way to look up how much your own doctor made. I decided to search for myself in the database to discover how much Medicare paid me.
Compared to the highest paid doctor – an ophthalmologist practicing in West Palm Beach by the name of Saloman Melgen – I made almost nothing. Now most ophthalmologists do pretty well, but this guy “made” over $20 million in 2012. Just from Medicare alone!
Well, when digging into the numbers, that doctor’s compensation was only $2.5 million. Office overhead cost $6.1 million and another $11.8 million went to “drugs and other” items.
The point that Dr. Melgen and others who have been singled-out by the news media have made is that either the highest compensated physicians are simply the one person billing on behalf of a large group of physicians or a huge chunk of the money paid to them is just being funneled from Medicare to pharmaceutical companies while only virtually entering the physicians’ hands.
In 2012, I never once saw a check from Medicare. I never held it, or stashed it in a bank vault, or did one of those Scrooge McDuck swimming through the money pit moments I remember from childhood. Instead, the $112,134 that Medicare paid me in 2012 went into a “lockbox” held by a large corporation that employs emergency physicians and contracts with hospitals to staff emergency departments. In fact, all the money for services for which I charged patients – whether the patient paid via Medicare, Medicaid, Kaiser, Blue Cross, or even out of their own pockets – ended up in that lockbox.
Some of that money made it to me. Of course, not all of it did. Some went to pay for the salaries of the people running that large corporation. And since that company is a publicly traded firm some of that money probably went to shareholders too. But, by no means did all of that $112,134 make it to me.
But the release of the data by CMS and the headlines from some newspapers will irresponsibly misled the public into thinking that thousands of millionaire doctors are driving around America in Masseratis and Bentleys at the expense of the American taxpayer.
Let us – for a moment – look at how much I got paid by Medicare. Specifcally, let us look at the care of the 60 sickest critical care patients that rolled into my ER in 2012. To care for those patients, which according to Medicare rules requires a minimum time commitment of 30 minutes, I got paid a whopping $181 per patient. Today I took care of a similar patient who, but for the grace of God and the skilled hands of myself and several emergency nurses, would have died. That’s only worth $181?
Maybe CMS timed this data dump to distract from the fact that the Senate approved a bill on Monday to cut further what Medicare already pays physicians. I certainly believe that Medicare overpays for some services (mostly procedures like those performed by those super-rich ophthalmologists) relative to others (intellectual services like primary care, psychiatry, etc.).
But I can tell you one thing.
Saving your life is worth more than $181.
Cedric Dark, MD, MPH