Expensive doctor vs cheap doctor.

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I am sure whining over expensive medical care is as common as talking about the weather, in most parts of the world. More so, if you are from India, you would invariably know someone who has had an awful experience with their doctor or hospital.

Hell hath no fury as a patient scorned.

So what separates a doctor who charges Rs. 2000 for his consultation from a doctor who charges Rs. 50? Let me try to explain.

• Qualification

Many times patients ask if it is okay to follow the advice of an alternative medicine practitioner. After some prodding, I find out that the reason patients go to an alternatively qualified medical practitioner ( like Ayurveda, Unani, homoeopathy, etc)  is that they charge lower fees.

Why do they charge less fees? mostly because their qualification was relatively easy to attain and has a fairly limited scope in application.  I agree that there are some diseases for which modern medicine does not has great results, but alternative medicine has better treatments.

Hence, the investment on part of the doctor in terms of time ( number of years spent acquiring qualification) is less in other branches compared to modern medicine. Hence,  they set up shop early and provide basic services for a lesser fee.

• Experience

As in most professions, more experience makes you better at giving consistent results. In the case of medicine, it is the key that separates great doctor from an average practitioner. Experience comes only after a lot of personal sacrifice of time and luxury. It makes sense to make up for those sacrifices in terms of higher monetary compensation.

• Investment

Technological advancement and modern medicine go hand in hand. Though primary principles of managing diseases have been similar since many decades, there has been a giant leap in involvement of technology and research to understand diseases, come up with better medicines, earlier diagnosis and less invasive management.

All the above-mentioned aspects add to the cost of healthcare, and the doctor who utilises those services eventually asks for more fees to compensate for his investment in technology and research.

• Insurance

Practise of medicine comfortably sits in the grey area of law system which sees things in black or white. Unlike other businesses, where products are either man-made or result

fairly predictable, in medicine neither of those criteria holds true. Human beings are neither designed by us nor are their responses predictable accurately. Which opens a wide gap for ifs and buts between the doctor, patient in the court of law. Hence, a doctor has to be prepared to bear the cost of such proceedings, which essentially translates into higher fees.

• Cost of education

Compared to other degrees, the cost of acquiring a medical degree is much higher. A strong reason for it is the lack of seats compared to the population of India. Also, as private colleges make providing medical colleges as a business model, there is an increasing trend in dilution of standard in medical education and an increase in college fees.

A lot of the above scenario also has to do with the caste-based distribution of medical seats compared to purely merit or scholarship based.

Some private colleges charge huge fees, and if it is considered an investment, then the doctor’s fees also become higher to make for the returns.

• Late bloomers

Doctors start earning fairly late compared to other professions. By the time a doctor is able to make enough money for himself and his family, his friends from other professions are already a decade or so into their jobs and have had their finances, investments and professional goals fulfilled in time.

For doctors, the pressure starts to build up fairly quickly in their thirties to make up for what their peers had been doing gradually in their twenties. Hence, it is not just compensation for money but also the time that eventually translates into higher fees.

Hope I was able to clarify the ever burning question in patients mind and give you a fresh perspective about medical care and as always, trying to improve doctor-patient understanding.

You can reach me here and here.!

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