So there was a neurosurgeon who called a plumber for a house visit.

The plumber arrived and after spending an hour bestowed the neurosurgeon a bill of $500. The surgeon was stunned; he said, “Even I don’t charge this much after a surgery.” The plumber stood up, gave him a sly look and said, “well that is why I am a plumber now; I used to be a neurosurgeon.”

I mention this as I was talking to a cardiologist few days ago. He said we are one of the few professions where someone else comes in and informs you how much you will get paid, regardless of what you do. Next time when you have a plumber at your house. try telling him what you want to pay him but do not hold your breath. Unfortunately, every year with Medicare cuts we are seeing more and more doctors changing the way they run their practices.

Now we can argue that physicians are still compensated well, but on the other hand they also do a phenomenal job in helping and saving lives. A bureaucrat sitting in his office can decide how much health care institutes and providers will be compensated. However, these bureaucrats do not get up in the middle of the night or drive 80 miles an hour to reach the hospital to save a life. Neither do they have to reach the hospital within 90 minutes because the sooner they perform the procedure, better the outcome. Nor do they perform a cardiac catheterization which literally saves lives.

However one thing they will never be able to share, is the sweet feeling of contentment about making a difference in someone’s life. By the way, this doctor after spending three hours will get a profligate check of $253.

A plumber was actually at my house this week. He charged me $50 for consultation and $260 for fixing a leak. He was out within an hour. On his way out I did ask him, “Hey were you a neurosurgeon before?”

S. Irfan Ali is a hospitalist who blogs at Human Factor in Medicine and Life.

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