Anecdotally Speaking

We call unsolicited promotional material in our mailbox junk mail and in our email spam. What do we call this stuff when it gets to us by fax machine? These "junk" faxes come to my office all the time and are constantly cluttering up my in-box mixed up with my regular paperwork. As soon as I see that it is junk, I toss it.

However, I wanted to share one with you. It starts out at the top in big letters "$20 For Your Opinion."

$20 For Your Opinion

Dear Dr. David;

Please follow the link below to participate in our partner's short survey.
In return for your valuable time, they will provide you with a

$20 Amazon.com Gift Certificate.

START NOW, HERE'S HOW: - Blah, blah, blah...

And help shape better services and information for both patients and physicians!

The reason why I wanted to pause and think about this one for a second is that I was having a conversation with my son about how much money I make. He made the comment that I make a lot of money, which is true. That has not always been the case. Both my wife and I come from families that struggled to make ends meet, and in the early years of our family life, we had our own epochal moments of financial struggle.

Indeed, however, we now are very blessed financially. My son is entering that time in his life when he is getting a perspective on what impact income has on a person's life, lifestyle, their choices and ultimately their future. He is weighing his options and measuring his values, as well he should.

My conversation with him got me thinking when I saw this enticement "$20 For Your Opinion." I remembered a survey I read many years ago where patients were asked what they thought the income was of their own doctor. Invariably, across the board, the patients underestimated the actual income of their doctors. The reasons for this are fascinating and could be the topic another time, but the question in my mind was, "Is $20 a good price for my opinion or not?"

My first reaction would be that the value of my opinion for a "short survey" must be $20 because they say it is. It is in print, in big bold letters at the top of the page, where everyone can see it and read it. It is authoritative, therefore, it must be true, my opinion for a short survey must be worth $20.

However, I have been around for a while and I am a skeptic. Besides, I do not need $20 that bad, so I am going to do some figuring, just for laughs and giggles.

I have a good idea what my opinion is really worth on the open market. It is what I do. I sell my opinion. My value derives from an accumulation of knowledge, experience and skills, which I apply with a measure of sound judgment.

So, I took the survey and determined that to earn the $20 Gift Certificate from Amazon.com it required ten minutes of my time. This promotional company is offering me a $20 Gift Certificate for ten minutes of my time. Ten minutes for $20 dollars. OK, got it.

That is a lot, is it not? I mean, that works out to $120 an hour. $120 an hour is a lot. How many jobs are there where a person makes $120 an hour? Especially jobs that are that easy? Sitting on your butt, clicking on buttons on an Internet computer screen for $120 an hour. Wow, who would complain, sign me up.

Except for one, little, tiny, itty-bitty, teeny-weeny, little, problem. We have 1,000 patients coming to our office every month that pay more than three times that much money for ten minutes of a doctor's time. Now, not all of that money goes into the doctor's paycheck, obviously. There are all of the overhead expenses, and all of that stuff. Nevertheless, even after overhead expenses are paid, I make more money for my ten minutes with the patient than $20.

So you say, "Of coarse you should make more for ten minutes seeing a patient, doing doctor stuff is a lot harder and everything. Making $20 for clicking a few boxes in a multiple-choice survey on the Internet is not the same thing, and so it is OK to expect less money, it is just an easier job. What, you don't expect some outrageous dollar amount just for clicking some boxes on a web page, do you!? You rich doctors are all the same!!! Just because you ...blah ...blah ...blah ..."

Yes of coarse clicking a few boxes is a simple job that is hardly worth paying someone to do. That is not the issue. The issue is what is the value of the time of the person that you are asking to give you time. As I said, I know what my time is worth on the open market. One thousand people remind me what it is every month. If you want to purchase my time for an activity that is important to you, at what rate would I be willing to sell you my time? At one third of my going rate? I think not.

Then who would do this kind of survey you ask? Good question! Now we come to my point. I think that there are two reasons this kind of thing exists. The first is the physician whose income is not exposed to the forces of the market. Let me give you two examples of this kind of physician.

The first example would be a doctor who was not seeing very many patients. In order for the amount of money you earn per patient encounter to impact the amount you earn per hour worked, you have to be busy and have a close to full-time practice. The less busy you are, the less you make per hour, the more attractive a low payment for your time will appear. The second example would be a doctor paid by salary or on a guaranteed income. Then any time spent gaining any extra income would be seen as a bonus, not as time taking away from a more profitably spent activity.

The second reason this kind of thing exists I think is more sinister. It is a scam, a fraud, a swindle, a rip off and a con. There are plenty of doctors out there that do not know what their time is actually worth. When they see "$20 For Your Opinion," they think either that their opinion is actually only worth $20, or there is an appeal to a part of them that actually feels guilty for making a lot of money. Yes, it seems ironic, I know, but if a doctor grew up in a poor family, as I did, then being offered $120 an hour for easy work might seem to them like stealing. It would not cross their mind that they were the one being ripped off by being offered only 1/3 of their going rate. This same type of doctor tends to undercharge patients too, and has a hard time making a go at it in private practice.

Do you know what the worst part of this is? This is why I know it really is a scam in sheep's clothing. This is what is at the end of the short survey:

"In order to send your voucher, we need some basic information. Please fill out the fields below, (mandatory fields are marked with an asterisk), and click on the "Submit" button."

Basic information, hah! Right! This is a list selling company. Fill this out, and you will get so many headaches, you will wish you had been paid way more than $20.

Pitch it. There is no easy way to make money. I like to make money the old fashioned way. I earn it. It is more fun that way anyway.