Higher pay for work outside of patient care undermines priorities

Finances are a big part of our lives. We may have become doctors to help people, but we're also supporting families.

The main job, for most of us, is to take care of patients. That's allegedly what we're most appreciated for, so shouldn't it be what pays the bills?

Patient care is still my bread and butter, but here are some dollar figures to think about:

(The following averages are NOT any sort of scientific data. They're based on my own experiences and phone calls to other neurologists.)

• Speaking for a drug company: $750 per hour.
• Legal work: $400 per hour.
• Clinical trials research: $350 per hour.
• Market research: $250 per hour.
• Actually caring for patients: $100 per hour (real money, not the amounts we charge insurance companies, knowing we'll never collect them).

I know that many nondoctors will look at the above and say, "$100 per hour sounds great! These docs should shut up and take it!" Those people, however, are not in the position of also having to pay for rent, malpractice insurance, staff salaries, office supplies, and student loans, each at five to six figures per year.

Do the priorities on this list seem screwed up to anyone else out there? Obviously, clinical research for future medications is important, but does it seem odd that I can make more money for legal work or market research than, say, directly helping people?

You bet. But they do pay more, and so many of us are rapidly gravitating to them as supplemental income. The economics don't give us many other choices. If we want to help patients, we have to be able to keep our practices open.

I think this is sad because, when we all started out applying to medical school, most of us just wanted to care for people. But these days that's the least valued thing we do.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Finances are a big part of our lives. We may have become doctors to help people, but we're also supporting families.

The main job, for most of us, is to take care of patients. That's allegedly what we're most appreciated for, so shouldn't it be what pays the bills?

Patient care is still my bread and butter, but here are some dollar figures to think about:

(The following averages are NOT any sort of scientific data. They're based on my own experiences and phone calls to other neurologists.)

• Speaking for a drug company: $750 per hour.
• Legal work: $400 per hour.
• Clinical trials research: $350 per hour.
• Market research: $250 per hour.
• Actually caring for patients: $100 per hour (real money, not the amounts we charge insurance companies, knowing we'll never collect them).

I know that many nondoctors will look at the above and say, "$100 per hour sounds great! These docs should shut up and take it!" Those people, however, are not in the position of also having to pay for rent, malpractice insurance, staff salaries, office supplies, and student loans, each at five to six figures per year.

Do the priorities on this list seem screwed up to anyone else out there? Obviously, clinical research for future medications is important, but does it seem odd that I can make more money for legal work or market research than, say, directly helping people?

You bet. But they do pay more, and so many of us are rapidly gravitating to them as supplemental income. The economics don't give us many other choices. If we want to help patients, we have to be able to keep our practices open.

I think this is sad because, when we all started out applying to medical school, most of us just wanted to care for people. But these days that's the least valued thing we do.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Finances are a big part of our lives. We may have become doctors to help people, but we're also supporting families.

The main job, for most of us, is to take care of patients. That's allegedly what we're most appreciated for, so shouldn't it be what pays the bills?

Patient care is still my bread and butter, but here are some dollar figures to think about:

(The following averages are NOT any sort of scientific data. They're based on my own experiences and phone calls to other neurologists.)

• Speaking for a drug company: $750 per hour.
• Legal work: $400 per hour.
• Clinical trials research: $350 per hour.
• Market research: $250 per hour.
• Actually caring for patients: $100 per hour (real money, not the amounts we charge insurance companies, knowing we'll never collect them).

I know that many nondoctors will look at the above and say, "$100 per hour sounds great! These docs should shut up and take it!" Those people, however, are not in the position of also having to pay for rent, malpractice insurance, staff salaries, office supplies, and student loans, each at five to six figures per year.

Do the priorities on this list seem screwed up to anyone else out there? Obviously, clinical research for future medications is important, but does it seem odd that I can make more money for legal work or market research than, say, directly helping people?

You bet. But they do pay more, and so many of us are rapidly gravitating to them as supplemental income. The economics don't give us many other choices. If we want to help patients, we have to be able to keep our practices open.

I think this is sad because, when we all started out applying to medical school, most of us just wanted to care for people. But these days that's the least valued thing we do.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.