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    Follow the money

    Ophthalmologists second to hematologists/oncologists in Medicare dollars


    I didn’t decide to go to medical school in order to make a lot of money. Rather, my purpose in attending medical school was to help people. If it were money I was after, I would have done what normal people who lust after ungodly amounts of wealth do—become an official for Fédération Internationale de Football Association (FIFA).

    Top-paying states for ophthalmic techs

    So, it makes me slightly embarrassed to read articles with titles like “Some doctors reap outsize share of Medicare payments” and see that ophthalmologists are second only to hematologists/oncologists in terms of receiving Medicare dollars. Medical oncologists come in a distant third, followed by cardiologists at number four, and radiation oncologists in the number-five position.

    Given that it is easier to find a cardiologist or radiation oncologist who is not wealthy than it is to find one of former Secretary of State Hillary Clinton’s e-mails, I can only presume my neighbors and acquaintances will see these news reports and suspect that I am (a) wealthy and (b) motivated to be an ophthalmologist by something other than altruism.

    One thing that is interesting about the Medicare data is how much goes to the top 1% of physician billers. They garnered 17.5% of Medicare payments in 2013, after receiving 16.6% in 2012. So these “one percenters” sure seem busy, and one wonders whether they have achieved the ideal work-life balance.

    Worst places to practice in 2015

    As the data breakdown shows, most (51%) of the payments consist of reimbursements for medications. That would logically explain why oncologists top the list, as well as the lamentable truth that among ophthalmologists, these tax dollars flow disproportionately to retina specialists who inject costly anti-vascular endothelial growth factor agents into the vitreous cavities of patients with greater frequency than President Bill Clinton can give $500,000 speeches. Only 20% of the payments are for exams and evaluations, while the next largest chunk (14%) is for surgeries and procedures.

    Next: What went wrong?

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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