Here’s your medical factoid of the day:
As of 2003, the average income of a French physician was estimated at $55,000; in the U.S. the comparable number was $194,000.
Personally, I’m a little frightened by the idea of my doctor not being highly paid. I don’t want my surgeon to be a member of the middle class. I hope that anybody who’s holding my heart in his hands is a highly trained professional, worthy of a ridiculously high salary. Medicine is labor intensive and high doctor salaries are inseparable from high health insurance premiums. But I’d rather invest in a better doctor than some fancy new diagnostic technology or unproven medical device.
That said, I think high doctor salaries do come with a burden. I wish more time and money was spent trying to improve the performance of medical professionals. I’ve recently read two excellent new books on this subject: Better, by Atul Gawande, and How Doctors Think, by Jerome Groopman. Both make the persuasive case that doctors don’t expend nearly enough effort trying to prevent cognitive and medical mistakes. And so emergency room doctors fall victim to false heuristics and surgeons forget to wash their hands. Radiologists display the confirmation bias and oncologists are swayed (unconsciously) by the gifts of drug companies. All of these errors are entirely preventable. If I’m going to invest in a highly paid doctor, I at least want that doctor to have seriously endeavored to improve his or her performance. As I’ve argued before, we need a new science of medical performance.
Update: I think it’s worth exploring a potential negative side effect of high medical salaries: over-confidence. A 1978 study found that the vast majority of surgeons believed the mortality rate of their own patients was significantly lower than the statistical average. (Another example of the “Lake Wobegon effect”.) A 1993 study that investigated the connection between the accuracy and confidence of a doctor’s judgment found zero correlation between the two variables. I’d be curious to see if French doctors, due to their reduced salaries, were less prone to over-confidence. I’m inclined to believe that over-confidence is one of the big obstacles that need to be overcome before we get a science of medical performance. After all, why should a surgeon try to improve their performance if they are already performing above average?