while you're right most of the billing pressure is likely coming from administrators and boards, doctors do participate with petty / pointless consults , excessive testing & procedures, absurd hour restrictions, and indirectly through medical boards reducing capacity, among other factors
>indirectly through medical boards reducing capacity
My wife has served on government medical advisory boards, and handles resident education. I've heard plenty of virtual meetings in the background. I've never once heard anyone discussing adding requirements for any unnecessary reason whatsoever. Not even a hint anything that would reduce capacity. If anything it's "how can we add capacity without reducing quality?"
>absurd hour restrictions
What do you mean by hour restrictions? The only hour restrictions that are enforced are on Residents and that is 80 hours per week.
If you're talking about doctors choosing to work less than 40 hours per week, that's general because they'll completely burn out. My wife is a pediatric ER doctor, she works less than 40 hours per week, but she has no set schedule and could be working 7a-4p one day, 1p-11p the next, and 10p-7a the next. For many of those shifts she's the only doctor there, and is responsible for the life and death of every single patient that walks through the door. She's the one who gets to tell a young mom that her 3 year old has a brain tumor, she's the one who has to code an already dead 5 year old found face down in a pool victim for an extra 15 minutes so her parents can get there because studies have shown it helps them process grief if they can see people doing everything they can to save their kid. And to top it off any mistake she makes could literally cost us our house because it's relatively common in our state for people to awarded judgements that are larger than malpractice insurance limits.
If she worked 40 hours a week she'd be completely burned out in 6 months.
>excessive testing & procedures
You can 100% blame fear of litigation for that. My wife is constantly balancing her desire to save patient's parent's money with her desire to get answers and her fear of legal liability.
>petty / pointless consults
You can blame fear of litigation for that one too. Calling in a specialist for a consult works the same as testing. It's a balancing act.
I know a lot of doctors, some of them are assholes, but I don't know a single one who even consider changing their treatment recommendations based on how much money it nets them.
I'm sure there is a noble excuse for every one of these problems. But the providers have the most leverage in reducing costs, so they must also accept the blame.
My complaint is two parts really. Providers are wasteful, and policy makers are not able to pressure them to optimize, because of the incredible PR.
In other words, there's no hope to reverse healthcare insolvency because cost growth will continue to explode with this combination.
