Specialists aren't so special

Here’s what one doctor, a specialist, has to say about our health care system: it is  "...a colossal network of unaccountable profit centers, the pricing of which has been controlled by medical specialists since the mid-20^th century…Each specialist performs the procedures that generate income for them, then passes the patient along. …They are corrupting our health care system.”

As to specialist societies, such as the American Association of Orthopedic Surgeons, another specialist says, “In the United States, physician specialty societies advocate not only for a higher volume of procedures for their members, but also for higher reimbursement per procedure.” In essence, specialists determine the services that are covered by insurance and the prices charged for them.

Both the physicians I have referenced (one at California's Permanente Medical Group, the other at New York's Mount Sinai Health System) believe we overvalue doctors who operate on people and undervalue the physicians who keep us off the operating table in the first place—our primary care physicians. The United States ranks first in the world in the proportion of specialists to generalists. In fact we have a national shortage of primary care physicians. Both the doctors believe that more resources and training should go for education and training of primary care physicians and that we should also pay them more. At the moment, they make less than half as much money as specialist.

In Switzerland, which ranks second in the world for health care quality, about 12 surgeons perform all total joint surgeries for the nation’s eight million residents. Because of this, they have about five to ten times the experience and expertise of their US counterparts. The US, with forty times the population of Switzerland, has about 5,000 surgeons who perform this procedure—which is more like one joint surgeon per 64,000 people compared to one per 650,000 in Switzerland.

As we all probably know by now, our health care system is the most expensive in the world yet ranks last out of 11 developed countries. Something is wrong with this picture.

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