Cream skimming triggers many doctors and all single-payer activists. It might be one of the most hated, uncollegial behaviours in medicine.
No one likes a colleague who takes all the easy patients and leaves the hard ones.
No one likes the idea of for-profit hospitals skimming all the easy cases and leaving the hardest ones for the public hospitals.
Why Cream Skimming?
Cream skimming exists because some patients are hard and others easy, even though each patient often carries the same fee. On top of that, some easy medical problems carry higher fees than harder ones.
For example, a toddler with a tiny laceration generates a visit fee plus a suture fee. It takes a few minutes to fix. Toddler leaves with a sucker in one hand, a wave in the other, and a huge smile on her face.
A weak and dizzy 80 year old with 6 non-English-speaking relatives often generates the same visit fee as the toddler, minus the suture fee. No smiles, suckers or happy parents.
It happens in all specialities. Cream exists: Some patients carry less risk, pay more, and require fewer brain cells to see.
Path to Incompetence
Committed cream skimmers cannot exist for long. No one became muscular by doing easy things. Easy guarantees mediocrity at best.
Cream skimming is the path to flabbiness in medicine. Doctors get mad at colleagues who “scoop all the easy patients.”
Doctors think that cream skimmers get ahead. Continue reading “Cream Skimming — Do We Need a Trigger Warning?”