* Schubert M, Grattan M. Crackdown on doctor rorts. The Age (Melbourne) 2009; 7 May.
The medical profession’s standing recently took a beating when the mainstream media ran banner headlines such as “Crackdown on doctor rorts”.* Records from 2008 showed that the top 10 per cent of in-vitro fertilisation specialists had each been paid up to $4.5 million through Medicare, including $2.2 million through the Medicare Safety Net, and a corresponding proportion of obstetricians had been paid $1.1 million each, including $612 000 via the Medicare Safety Net, prompting accusations of excessive increases in some specialists’ fees.
† Two kinds of wealth [editorial]. JAMA 100 years ago: April 25, 1908. JAMA 2008; 299: 1964.
This unsavoury matter of doctors’ earnings echoes a 1908 JAMA editorial titled “Two kinds of wealth”,† which stated:
A few days ago a famous American surgeon told a friend that it was a constant mortification to him that for his life-work he had not chosen business rather than medicine; and yet the annual income of this particular surgeon from practice is perhaps $100 000. Also a few days ago at [a] testimonial dinner ... Andrew Carnegie, who has gathered, who has given away, and who still has left more money than any other one individual, said that he would give all his worldly wealth for the immaterial wealth of many of the physicians there before him ... Why does the surgeon with the income of a prince, but not of a Carnegie, hunger for the millions, while the industrial Croesus would gladly give all his many millions for the medical man’s mind and vocation? ...
The answer to the riddle is really not hard to find. On the surgeon’s part, it comes to view at once. He practices medicine for any and every reason but the right one. He values money at more than its worth.
Sadly, it is this facile judgement that is implicit in the current media accusations of medical rorting. In the absence of all the complexities of context, such pronouncements remain trite. Where is any accompanying analysis of the very real cost of providing high-quality care? It is time these materialise, otherwise sensationalism reigns supreme.
The Medical Journal of AustraliaMartin B Van Der Weyden, Editor.
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