What Surgeons Get Paid, and What Patients Think Surgeons Get Paid

(Photo: kcxd)

Jared Foran, an orthopedic surgeon in Denver, is a co-author of a new study called “Patient Perception of Physician Reimbursement in Elective Total Hip and Knee Arthroplasty” (PDF here). The authors surveyed 1,200 patients to see how much they thought orthopedic surgeons should make and what Medicare actually pays for a hip or knee replacement.

In an e-mail, Foran describes their results:

On average, patients thought that surgeons should receive $18,501 for total hip replacements,  and $16,822 for total knee replacements. Patients estimated actual Medicare reimbursement to be $11,151 for total hip replacements and $8,902 for total knee replacements.  Seventy per cent of patients stated that Medicare reimbursement was “much lower” than what it should be, and only 1% felt that it was higher than it should be.

In reality, surgeons get paid on average $1,378 for a total hip and $1,430 for a total knee.  Thus patients were off by an order of magnitude in their estimates!  The disconnect in public knowledge seems extreme.

In short, patients — the most important part of all of health care policy decisions — have absolutely no clue how much doctors get paid.  They think we get paid (or, at least, deserve to) about 10 times more than we actually do!

Foran tells us that similar studies have been done for spine surgery and sports medicine, with similar findings.  

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  1. SAO says:

    If the average person thinks doctors get paid 10 times what they actually get paid, then any public opinion that Medicare underpays is pretty worthless. That being said, to what extent do patients pay attention to the break out of costs. Between the cost of the device, the hospital fees, the nursing, radiology and anesthesiology what is the cost of a replacement?

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  2. Benjamin says:

    I wonder if there is a disconnect in perception. There is a clear difference here in how much is paid for the surgery, and how much the doctor or surgeon actually receives. My thoughts are that many of those questioned may be answering how much they think these surgeries cost, rather than how much a doctor or surgeon receives for the actual procedure. It has been my experience that a great deal of population is unaware of the disparity between the cost of items, and the profit or compensation received for selling those items.

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    • DanSanto says:

      My brother’s knee replacement was over $22,000 by the time all was said and done. I’m sure the surgeon only received a portion of that.

      I also suspect the question’s responses are being skewed by what the respondents have in mind for the total cost.

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      • Stew says:

        If you look at the pdf link, the survey attempts to clarify: “The fee includes the operation itself, the time your surgeon spends with you in the hospital and his or her care for you for 90 days after surgery. The fee DOES NOT include preoperative evaluation or the fee the hospital gets paid.” quote from the article.

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  3. jeff says:

    Hidden due to low comment rating. Click here to see.

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  4. Valpey says:

    This is about as useful as a survey of parents of what they think a public school teacher should be paid per student per hour of instruction.

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    • Neil (SM) says:

      What a coincidence! I’m not a doctor or a teacher, but I likewise think I deserve to get paid about 10 times more than I actually do!

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  5. Eric says:

    Of course patient estimates are high. It’s asking the guy who just had his knee replaced how much of someone else’s money he would give to the doctor who just made his life much better. I’m surprised the dollars weren’t measured in gajillions.

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    • AK says:

      I think its more to do with people seeing their doctor’s bill or talking to friends about the doctors bill for these surgeries. So the hospital charges 20-30k for the procedure, so of course people may think doctors make 15k for a procedure. After all the paying professions are bankers, lawyers, and DOCTORs are all.

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  6. jdwvu says:

    That is just what the surgeon actually pockets…the total cost of surgery is much closer to the 18k

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    • Wupp says:

      This is not what the surgeon “pockets.” After expenses, including paying his office staff salaries, rent/mortgage on his office, and other expenses, surgeons pocket less than $500 for this procedure.

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  7. KevinM says:

    If you seek a likely source for the misperception, look no farther than that physician’s bill. It bears no relation to what Medicare or an insurer will pay — in fact it is probably off by the “order of magnitude” of which you speak.

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  8. mph says:

    The respondents are probably thinking of the total cost of the procedure (hospital, anesthesia, etc.) rather than the surgeon’s personal share.

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