Responses to a recent WSJ op-ed wondering why patients have so many doctors:

The implication that average physician compensation is around $1 million is absurd; it is closer to $200,000. He also fails to mention that payments for “physician services” are only 21% of total health spending. There is data to suggest that reduced spending on physicians actually drives total spending higher due to effects on volume and quality. . .

. . . The elephant in the room that Dr. Bach does not mention is the liability physicians face when they do not refer a patient to a “specialist” and something untoward happens . . .

. . . Patients want the care of specialists. For example, a diabetic patient with heart disease, neuropathy and insulin dependence will be cared for by a cardiologist, neurologist and endocrinologist. Clearly, cancer patients at Sloan Kettering will be cared for by an oncologist and a host of other specialists, with little contribution from a primary care physician . . . It is not fee for service driving this trend, but rather the desire of patients for what they see as the best care. . .