So last week I talked about how physicians make money not just off of seeing patients but also off of the “mark-up” for medications given in the office. I was asked by the editorial writer at what I really thought and here is what I said:

1) This is only one payer although these are the most expensive patients for the most part. In Alabama, physicians make most of their money form BC/BS so this is only a part of the picture

2) The number is not the take home pay. Think of it as an inventory that they sold. Having said that, physicians take home a lot of money. Orthopedists took home over $400,000 on average in 2012. Even he lowest paid took home $175,000. To do that, though, they shave a little off of everything on that list.

3) There’s a lot on that list that physicians sell that doesn’t make the patients healthier. Next time you as a patient are offered a steroid shot for your cold, question whether or not it is necessary or might it contribute to the chance you will get diabetes. Doctors are doing a lot of stuff to people because people expect it and because insurance pays for it. Under the new insurance plans a lot more little stuff that doesn’t work like steroids for colds will be paid for out of the patient’s pocket. Having a doctor you trust might allow you to ask “is this really necessary?” In fact, you might even be able to ask it via e-mail.

THEN I was asked to put it into layman’s terms and (with A LOT of help from others) we came up with “The tomato version of Medicare spending.” I  will suggest that you go here to read it if you want a neat explanation or ever went to the store hungry for a tomato sandwich and ended up with heirloom tomatoes, foccacia, Maytag blue cheese, and a bill for $200 and wondered “why did I do that?”