Making a Case for Not Cutting Radiologists’ Salaries

July 28, 2014

When it comes to healthcare spending, salary cuts may not be the best approach.

Doctors are in the driver seat of health care but they mostly do not benefit monetarily from the health care spending in the United States. I recently came across an article in The New York Times: Busy Doctors, Wasteful Spending. This article addresses the issue with physicians seeing more patients and performing more procedures in order to compensate for payment cuts which may, in turn, increase health care costs rather than decrease costs.  

About 20 percent of health care costs are directly paid to physicians, 50 percent of that is used to pay overhead, including practice expenses and medical malpractice, leaving only 10 percent of the pie for physician salaries. The trillion dollar answer on how to curb health care costs is not by cutting physician salaries, which will only directly address 10 percent of the spending. 

Radiologists are at the center of physician payment cuts. Over the past decade we have seen reimbursements for our services drop over 50 percent for many procedures. Currently, Medicare will pay on average $11 for a radiologist to read a chest radiograph. I cannot imagine any more cuts in imaging, as I feel as though I am already feeling the pressure of reading more and more each year. [[{"type":"media","view_mode":"media_crop","fid":"26104","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_9714229924138","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2483","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; height: 248px; width: 440px; float: right;","title":"Impact on global outpatient payments of Medicare reimbursement cuts for imaging services performed at outpatient imaging centers of Southwest Diagnostic Imaging Ltd. Courtesy of Rodney Owen, MD, FACR. Image Courtesy of Radiology Business. ","typeof":"foaf:Image"}}]]

Cutting physicians’ salaries seems counter intuitive. It would be analogous to placing a mandatory cut on teachers’ salaries to reduce educational costs. In the short term, this would seem logical since by cutting teachers’ salaries, the expenses would decrease, however, the long term effects would be detrimental to the outcome of educating our children. Fewer high-quality candidates would decide to go into teaching, leaving less-qualified or less-educated individuals to teach young Americans, eventually leading to worsening of the U.S. education system.

Similarly, by cutting physicians’ salaries, it would eventually lead to fewer top-tier students going into medicine and would allow middle- to lower-tier students to go into medicine. The perception of choosing a career path in medicine would evolve and would likely not maintain the high level of respect and value it currently receives. Also, the end result of saving lives and improving health care would suffer.

It is interesting to see how many administrators are focusing on the physicians’ incomes when hospitals, ancillary services such as ambulance transportation and durable medical equipment companies, and prescription drug prices are huge factors in the U.S. health care environment. Cutting physician salaries will only plug one of the holes in the sinking ship. A larger overhaul of the U.S. health care system needs to be implemented in order for the industry to continue to move forward and to enhance the lives of our country while maintaining costs.