The Dr. Advocate

As a student of health services and a consumer I want to be able to utilize healthcare that is quality and affordable.  For the sake of the article I am saying quality simply means can I go to the doctor with the expectation that I will get better. Will I be able to visit the doctor without having to enter into an indentured servitude contract?

I ran across an article by an anesthesiologist who wrote about playing at the top of her license.  Although she is an anesthesiologist one can quickly tell she is gifted with the pen. As her undergraduate education is in English. The title is Scope of Practice: Playing at the Top of my License. She did a simple workflow analysis of her day and asks how can she best utilize her time?  According to her estimate she spent 22 minutes doing things that others could do. I like looking at things from a perspective of how will it affect my pocket.

Regardless of what one thinks the doctor charges a higher fee than a nurse and certainly higher than the cleaning crew. We could certainly look at things from the perspective that if the doctor is changing canisters when patients are waiting to get treated we there is ineffectiveness in the process. Here is a comparison using Chicago as the location of a facility for no particular reason.

Worker	Salary	Per Minute	22 minutes	Annualized
Anesthesiologist	$        412,000.00	$            3.30	$         72.63	$  26,146.15
Nurse	$          49,359.00	$            0.40	$           8.70	$    3,132.40
Janitor	$          29,968.00	$            0.24	$           5.28	$    1,901.82

I know that some would understand this reasoning intuitively but, I like pictures so I took the information from Salary.com for the Anesthesiologist, Nurse (LVN), and Janitor. We can see that if we look at this one procedure where she has taken 22 minutes of her time to change a canister, administer an IV, as well as filling syringes and label the medication.  I am not saying there is no value in the tasks but there certainly is a difference in cost. At almost 20 times the original cost there is certainly some room for adjustment around the anesthesiologist.

These same bureaucrats and administrators eliminate lower-paid personnel–desk clerks, transport orderlies, and dictation typists, for instance–to trim their budgets, with no regard for how much they prevent physicians and nurses from truly practicing at the top of their licenses. Someone still has to do the tasks that were previously done by those employees, and that someone, too often, is a physician or nurse.  Karen S. Sibert, MD

I wonder as a consumer that perhaps the other way around, lower paid personnel should be hired based around care and treatment. So that I can get my best bang for my buck.

As an extra there is a study done by Scala, Michael where attributes the changing of canisters at about 3 minutes time and a cost of $3.42 in 2011 dollars.