so.. how much?

[karlugato]

How much do doctors really make per circumcision and how many a day do they do on average? I'm having a.... lets say discussion on this and can't really find any good info on it. Thanks!

[brant31]

That's a tougher question than you might think. Lots of variables: physician specialty, region of the country, age of the child, etc.

Also, the total of the fees are hard to calculate, because there's the direct physician charges, the materials charges, nurses' time, facilities utilization, etc. There is no standard set of charges.

But in terms of what the doctor himself or herself makes per neonatal circumcision, you can use $150-350 as a guide. Call it $225. A light week for a doctor who does regular circumcisions is 5-15. Call it 10.

So, average doctor gets 10*$225 or $2,250 a week. Let's say doctor takes 4 weeks vacation, so does circumcisions the other 48 weeks. That's $108,000 a year for about 3 hours work a week.

Even a doctor who does "occasional" circumcisions in a low-cost area makes out well. A doc who performs 4 circumcisions a week at $155 a pop makes $620 extra a week, or almost $30,000 per 48-week year.

Every doctor I know scoffs and says, "Don't be ridiculous. Nobody makes any money doing circumcisions." The truth is that circumcision pays very well, at least enough to make a serious dent in their kids' tuition fees or more than the monthly payments on a Lexus or Mercedes. Or a boat. Or a pool. Or a kitchen remodel.

[karlugato]

I knew it was a tough one. That's why I had to ask. The way you broke it down really shows what a cash cow this procedure really is. I hear the same argument so often about how little they make, but ... well.. you summed it up about as well as anyone could. Thank you!

[knitted_in_the_wom]

Originally Posted by brant31

But in terms of what the doctor himself or herself makes per neonatal circumcision, you can use $150-350 as a guide.

Well, in my area a circumcision costs $300 from a pediatrician or OB/GYN-which to me seems INSANE for a 10-15 minute procedure! But wait...it gets better! I know someone who paid a mohel $800 to do it--though I will mention that the mohel was brought in from a major metropolitan area about a 2 hour drive away.

Looking at that typical $300 fee though...I'd guess that barely $100 of it will make it to the care provider. But still...if a care provider does a couple a week...yeah, it is significant.

[vachi73]

Also consider...

When done in a hospital setting, as many or even most are done these days, the hospital also gets a facilities fee, etc. I don't know how much it is, do you Brant? It is probably more or less set by CMS with slight regional variation. I'm guessing $250 or so, some of which the hospital actually collects (call it $100 per procedure).

Then, some hospitals reportedly sell the "tissue" (foreskin) to cosmetics and/or pharmaceutical companies, so that's more $$. No idea how that works, nor if it is an urban myth, but still...

Never hurts to follow the money associated with circumcision. Certainly changes the cost benefit analysis by physicians who do circs, and the hospitals where they're done.

[brant31]

The last discussion I had with a Pediatrician about this issue indicated that the true "all-in" cost of a neonatal circumcision is about $700-800, if you itemize each aspect: operator fee, support staff time, materials (both one-time use, as in draping and Plastibell, as well as sterlization of durables), facilities use charges (some hospitals bill room use by the minute), and the occasional extras to address bleeding issues, etc. I believe the facilities charge was along the lines of what you suggest, $200-350. There is often a negotiated lower rate with the insurance companies.

Hospitals don't need to sell many foreskins; a little goes a long way toward either cosmetics research or growing new burn tissue. Nevertheless, ALL such tissue ought to be discarded in standard practice as medical detritus; i.e., hazardous waste. It's human body parts.

And proper anesthesia for neonatal surgery would render the tissue effectively useless for research or cell farming, which no doubt irritates some hospitals or doctors who have been accustomed to harvesting pristine tissue. Now, with some hospitals eating the cost of circumcisions because Medicaid won't pay, the "boy coupon" is looking less and less appealing.

Hard going for those who fed at the trough for 60 years.

[Leav97]

All of the Dr.'s I see are salary. They don't make money of individual procedures.

[Drummer's Wife]

Originally Posted by Leav97

All of the Dr.'s I see are salary. They don't make money of individual procedures.

Same here. It's interesting, b/c the quote about docs potentially making $108k alone on just circs seems odd to me b/c there are docs, including peds, in some areas who don't even make that much a year all together. Others may make $150kish a year, on salary. Maybe these are OB's and not Pediatricians? I'm not saying it isn't true that some docs out there earn additional money for every circumcision they perform; I just don't think that's truly the norm. The hospitals, however, are a different story.

[karlugato]

...

[karlugato]

Originally Posted by Leav97

All of the Dr.'s I see are salary. They don't make money of individual procedures.

Very good point. It's something to consider. If that is the case though I'm still surprised that there are so many doctors willing to perform this procedure.

[A&A]

Originally Posted by vachi73

Then, some hospitals reportedly sell the "tissue" (foreskin) to cosmetics and/or pharmaceutical companies, so that's more $$. No idea how that works, nor if it is an urban myth, but still...
.

Not a myth at all, unfortunately. Foreskin has a myriad of uses in skin and cell research.

[vachi73]

Physicians and salary

Although most physicians are salaried, in virtually every case I know of (I work in health care), the salary includes a portion that is paid on "productivity." that portion reflect how busy a doctor is and how much revenue she/he generates. So, although doctor may not literally get $150 for each procedure he/she does, it is fair to assume that those procedures do "count" toward the bonus portion of pay.