What my mother doesn`t understand: How can doctors live with themselves charging $250 for a 20-minute non-insured consultation?
Last year, one of my closest friends experienced something that significantly impacted both of us. Out of nowhere, he had a massive anxiety attack, which he had never experienced before. As if that wasn’t enough, he was also dealing with pelvic pain that needed medical attention. We decided to visit a urologist for his pelvic pain, and while the urologist did provide some advice, he referred us to a psychiatrist for the anxiety issue.
We booked an appointment with a well-known psychiatrist, whose name was often mentioned with respect in the community. When we arrived at the office, we were met by an assistant who rudely informed us that we were late, even though the appointment time had never been clearly communicated to us. Her scornful attitude left us feeling uneasy, especially considering we hadn’t even met the doctor yet. The thought that we were being judged before receiving any care was unsettling.
When we finally met with the psychiatrist, he quickly diagnosed my friend’s issue as a minor panic attack and prescribed Xanax. The consultation lasted about 30 minutes. We were somewhat relieved that the situation wasn’t more serious, but that relief was short-lived when we received the bill. The prescribed medication cost a mere $6, but the doctor’s consultation fee was an astounding $250.
This situation left me grappling with a question my mother often asks: Why do doctors need to charge such high fees? I understand that medicine is a complex field that requires years of education and training, but the idea of paying $250 for a brief consultation seemed excessive, especially when the treatment was so straightforward. After some reflection, I realized that there are multiple facets to this issue that need to be considered.
The Market Sets the Price
The concept of supply and demand is one of the most basic explanations for why doctors charge high fees. In many areas, especially those with a limited number of specialists, doctors can charge more because there are fewer alternatives available to patients. This market-driven pricing can lead to high consultation costs, particularly for uninsured or underinsured. The logic here is that if people are willing to pay the price, the market will continue to support it.
However, this raises ethical concerns. Healthcare is not a luxury; it’s a necessity. When market forces determine the cost of healthcare, it often leaves the most vulnerable populations — those without insurance or with limited financial resources — facing significant barriers to accessing care. It’s hard to reconcile the idea that something as essential as healthcare can be priced out of reach for many simply because the market allows it.
Proper Allocation of Talent to the Problem
Another reason for high consultation fees is the value of specialized knowledge. Becoming a doctor, especially a specialist like a psychiatrist, requires years of rigorous education and training. This long journey includes undergraduate studies, medical school, residencies, and often additional fellowships. The knowledge and expertise these professionals acquire over this time is invaluable, and in many ways, the fees they charge reflect this accumulation of expertise.
When you pay a doctor for a consultation, you’re not just paying for the 30 minutes they spend with you. You’re paying for the years of education, the sleepless nights, the countless hours spent in hospitals and clinics, and the ongoing commitment to learning and staying current in their field. It’s an investment in their ability to provide accurate diagnoses and effective treatments. From this perspective, the $250 fee is not just for the immediate service but for the assurance that you’re being treated by someone who is highly qualified.
Incentives for Accountability and Transparency
High fees can also serve as a mechanism for accountability and transparency in medical practice. By charging higher fees, doctors may feel a stronger obligation to ensure they are providing high-quality care. The pressure of commanding a high price might encourage them to maintain the highest standards in their practice, knowing that patients expect the best when they are paying a premium.
However, this system is not without its flaws. If high fees are not accompanied by exceptional care, patients are left feeling exploited. There’s a delicate balance between charging enough to reflect the value of the service and ensuring that the service provided justifies the cost. In my friend’s case, the rushed nature of the consultation and the indifferent attitude of the office staff didn’t align with the premium fee we were charged.
Hierarchy of Prices According to Availability
The availability of specialists also influences pricing. In areas with few psychiatrists, those who practice can charge more because their services are in higher demand. This creates a hierarchy where the cost of care is directly related to the availability of providers. While this might make sense from an economic standpoint, it often results in inequitable access to healthcare.
For patients, this can be frustrating. It’s difficult to accept that the cost of care can vary so dramatically based on where you live or how many specialists are in your area. This is particularly true in rural areas where access to healthcare is already limited, and patients might have to travel long distances and pay higher fees to see a doctor.
Incentive for Doctors to Keep Practicing
It’s important to remember that the journey to becoming a doctor is long and expensive. Medical education is costly, and many doctors graduate with significant debt. High fees help ensure that doctors can pay off their loans and achieve financial stability. Moreover, the demanding nature of the profession requires continuous learning and updating of skills, which also comes with costs.
In many ways, the fees charged are not just for the immediate service provided but for the years of investment in becoming a specialist. While this doesn’t necessarily justify exorbitant fees, it does provide some context for why consultations can be expensive. Patients are paying not just for the doctor’s time but for the years of training and education that make their expertise possible.
One Possible Solution: Assume Ownership of Your Claim
One way to address the issue of high fees is for doctors to take more ownership of the billing process. Rather than delegating the collection of fees to office staff, doctors could personally discuss the cost of the consultation with their patients. This would force them to confront the reality of what they are charging and consider whether it is truly fair.
If a doctor cannot look a patient in the eye and justify a $250 fee, perhaps it’s time to reconsider the pricing structure. By taking ownership of the billing process, doctors can ensure that they are not only providing excellent care but also charging a fee that reflects the value of that care in a transparent and fair way.
My Question to Doctors
Ultimately, my question to doctors is this: Can you look your patient in the eyes and ask them for $250 for a 20-minute consultation? If you can’t, then perhaps it’s time to rethink your pricing. Patients come to you in their most vulnerable moments, seeking help and reassurance. They didn’t choose to be sick, and they had no choice but to seek medical care. As a doctor, your role is not just to treat the illness but to do so in a way that is compassionate, fair, and respectful of the patient’s financial situation.
Charging high fees might be justified in some cases, but it should always be done with consideration for the patient’s experience. After all, healthcare is not a luxury; it’s a fundamental human need. If you’re going to charge a premium, make sure the care you provide is worth every penny. And if it’s not, have the courage to adjust your prices accordingly. Patients' trust in their doctors is sacred, and financial concerns should never be compromised.
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