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Practitioner Availability and Behavior
ОглавлениеDefensive medicine and the high cost of medical malpractice insurance all add to increasing physician costs. Malpractice claims in the United States are filed 50% more often than in Great Britain and 350% more often than in Canada (Anderson, Hussey, Frogner, & Waters, 2005). Two‐thirds of claims in the United States are dropped, which results in a similar distribution of claim settlements among these countries. Regardless, the need for medical malpractice insurance to protect American physicians against such claims contributes to the cost of physician care. There are many calls for malpractice reform.
The U.S. has less fewer doctors, especially psychiatrists per capita in the U.S. than there are in most comparably wealthy countries and the U.S. has a similar number of nurses per capita (Sawyer, Sroczynski, & Kaiser, 2016). This shortage is most pronounced in certain practice specialties, for example, family practice physicians and geriatric physicians. Physician shortages are also apparent in rural areas. U.S. physicians earn more than physicians in most countries. A physician specialist who makes $300,000 in the U.S or a family physician whose income is $175,000 per year in the U.S. would, on average, earn approximately 25–50% less in Canada (Eisenberg, 2006) (Table 2.5).
Table 2.5 Health Care Compensation
| Annual salary | |
|---|---|
| Allergan CEO Brent Saunders | $6,624,473 |
| GlaxoSmithKline CEO Emma Walmsley | $7,662,210 |
| UnitedHealth Group CEO David Wichmann | $18,107,356 |
| Cigna CEO David Cordani | $18,944,045 |
| CVS Health CEO Larry Merlo | $21,953,040 |
| Chief Executive Officer (CEO)–Non‐MD | $158,193 |
| Chief Executive Officer (CEO)–MD | $275,123 |
| Director of Human Resources | $96,388 |
| Medical Director | $222,229 |
| Director of Nursing | $84,922 |
| Nurse Practitioner | $93,281 |
| Physical Therapist | $70,568 |
| Cardiologist | $254,945 |
| Anesthesiologist | $291,631 |
| General Surgeon | $270,741 |
| Family Medicine MD | $182,882 |
| Emergency Care MD | $220,642 |
Source: Salary Comparison, Salary Survey, Search Wages. (2019). Retrieved October 5, 2019, from www.payscale.com and Ramsey, L. (2019, May 16). Health care CEOs make as much as $26 million a year. Here's what the industry's top executives earned in 2018. Retrieved from www.businessinsider.com/pharma-and-healthcare-ceo-compensation-2018-2019-4.
Physicians can be extremely persuasive in health care and hospitals as they advise patients where to go for treatment. The physician represents the primary source of patients for most hospitals. A physician affiliated with two or three hospitals can steer patients toward any of those hospitals. This power over admissions is one of the most important forces in the hospital. Physician control over admissions also affects nursing home admissions, home care agency patient referrals, and referrals to other physician specialists.
