Thursday, July 31, 2003
(5:58 PM) | Adam Kotsko:
Foiled again!
As regular readers know, the chief doctor at the chiropractic office that employs me has been on vacation for most of the summer. At first it seemed to be for health reasons, but I'm skeptical now. In any case, today the doctor who is second-in-command asked me if I had a lot of payments come in the last couple days, because his collections for the month were way down so far. Sadly, I didn't have anything that were likely to affect the statistics significantly. I ran a report on the computer after he went back with patients, and it said that collections from his patients were down by $12,000. Clearly, that sucks, but to put it in perspective, I decided to check the collections for the whole office. It turns out the whole office was down by $14,000, so almost the entire drop in revenue was apparently his fault.
Except that it's not. Since he's been in the office for so long, most of the head doctor's patients prefer to see him; he estimates 75% of them do. This doesn't lead to much of an increase in workload for the lowest-ranking doctor, but it's obviously a big increase for #2. As a result of having to see so many of the big man's patients, he doesn't have as much time for his own, so one of his previous biggest selling points -- that he was very flexible and able to see his patients at nearly any time -- was suddenly gone. So on top of having to do all the head doctor's paperwork and having a lot more patients to treat, now, due to the way the system is set up, he's going to be making less money for doing more work.
Of course, one might argue, it's his own fault for not starting up his own office. If he'd taken the risks and responsibilities of owning a business, then he would make money proportionate to the amount of work he puts in. Let's take a look at this argument, though. First off, the big man is not making money proportionate to the amount of work he's putting in, because he's making at least some money for doing no work. Second, he's not taking any real risk by leaving for just a few months, because he's able to keep up his lifestyle by exploiting his associates. If he keeps it up indefinitely, then everyone's just going to leave, but it's likely that he has enough resources saved up that he could live comfortably the rest of his life. So after a certain point, it would appear that owning your own business is a way of putting the tedium of risks and responsibilities behind you.
I do think that every business needs a boss, and I'm not opposed to the boss getting paid more in proportion to the responsibilities he takes on. I don't think that the boss should be able to set up the system so overwhelmingly in his favor, though. It's like saying, yes, every card game needs a dealer. That much is indisputable. But that doesn't mean the dealer should be able to stack the deck. To extend the metaphor further, it doesn't mean the dealer should be able to use his earnings, derived from stacking the deck, to bribe the card company into changing the rules in the dealer's favor.
Granted, this is a small example, and it's ultimately not that big a deal. I also don't delude myself that I'm going to find a whole lot of companies or work situations where it would be better -- and that's exactly the problem. This is just the way our system is set up. This lazy class of irresponsible rich people, with nothing better to do than exploit workers and exercise hugely disproportionate influence on public policy, is what's holding America back.
UPDATE: Probably no one will read this, but anyway: the doctors don't get bonuses based on collections, but rather on "production," which is the number of charges incurred by the doctor's patients, less any adjustments. The assumption is that collection will follow production eventually, but the longer a doctor goes with low collections, the more likely he will have to either write off a patient's account or send them to the collection agency (both options require a massive write-off which brings production down). I don't think this changes my main point, and I also don't think it's that big a deal whether a doctor gets his bonus or not, but I felt I should be fair to my own employer. If you're sick of my half-cocked diatribes based on only marginal evidence, I suggest you read Slacktivist, who has several good posts up.
