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  1. #1
    CareerRuined is offline Newbie 510 points
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    Why Are Polish Doctors Underpaid?

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    I found it funny that the average Polish doctor made less than the average person in Poland (the roles are reversed). I am assuming that this is because as a group, they are not as aggressive in asking for more? After all, out of all people, doctors have the most leverage, since they are dealing with people's lives...

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    waltfw is offline Senior Member 519 points
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    Without knowing too much about Poland's healthcare system, I'd hazard a guess that low salaries are partially due to a lack of collective bargaining rights, limited advocacy and lobbying, and a 3rd party payer and approval system.

    Most countries don't allow physicians (and many other professionals) collective bargaining rights. That is, physicians can't strike, they can't collude with each other to set prices, and so on. Countries in which physicians are highly paid generally have organizations and rules that substitute for collective bargaining in some way. For example, in the US there are strong political lobbies and advocacy groups that actively work to keep salaries (for employed physicians) and insurance reimbursement rates (for physicians with their own practices) high.

    The other big factor is that modern healthcare systems are nationalized and involve a 3rd party in determining what services the physician will provide and how much that physician will be reimbursed. In Poland (and much of Europe), that 3rd party is the government, and private insurers that work closely with the government. The objective for these 3rd party payers is to drive costs down- i.e. lower reimbursements which in turn results in lower physician salaries. Consider also that the 3rd parties are less likely to approve costly treatments, especially when there are less expensive alternatives (even if those alternatives are potentially less effective). There's also limited ability for customers (patients) to offer more in compensation because generally physicians aren't allowed to take money on the side - i.e. if they want $100 for an office visit and an insurance company only pays $40, they can't go after the patient for the difference or even accept money if the patient offers it. In much of Europe, and I suspect Poland also, the amount insurance companies pay out is basically set by the government, so physicians need to lobby if they want more money. Combined with few collective bargaining rights and the lack of a powerful lobby and advocacy groups, the result is lower compensation.

    It could be also that Polish people value healthcare less than other countries do and are willing to accept the trade offs that come with paying less.

    But really, money is a touchy subject when talking about healthcare. Most people don't consider health a commodity, so suggesting that physicians simply refuse to treat patients (like any other professional would do if they were underpaid) doesn't usually go over well. Consider that physicians who demand payments under the table (to compensate for low salaries) are considered corrupt and guilty of taking bribes.
    Last edited by waltfw; 02-23-2011 at 07:17 AM.

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