To get an idea of what the U.S. public thinks an orthopaedic surgeon should receive for hip and knee replacement procedures, a group of researchers surveyed 1120 patients, asking them to come up with estimates.

Based on the study, titled "Patient Perception of Physician Reimbursement in Elective Total Hip and Knee Arthroplasty," patients guessed that surgeons should get paid an average of $14,358 for total hip replacements and $13,332 for total knee replacements.

As the headline points out, those estimates were way off compared to what these clinicians actually receive from Medicare. On average, surgeons receive $1378 for total hip arthroplasty and $1430 for a total knee arthroplasty from Medicare.

In recent years, there has been a trend towards gradual Medicare physician reimbursement while the cost of physicians' operating expenses and the cost of living has risen. In light of this, a number of joint arthroplasty surgeons are opting out of Medicare although the majority of them still accept it. 

One telling paragraph from the study explains that: 

Unexpectedly, nearly one fourth of respondents provided comments at the end of the survey. The comments were perhaps more telling about patient perceptions then were the numerical data. Comments were often several paragraphs long and often conveyed passionate opinions regarding the subject matter. Many patients expressed alarm at the low value of Medicare reimbursement. The following phrases frequently appeared: “I am shocked,” “I am surprised,” “I don't believe it,” “I am ashamed,” “this is unfair,” “it's a great injustice,” “this is scandalous,” “it is an insult,” and “it's a bargain.” One patient stated, “It shows how little public knowledge there is about this area.”

As Uwe E. Reinhardt, professor of political economy at Princeton University pointed out in a 2007 editorial to the New York Times, cutting physician's pay in itself is not sufficient to fix the healthcare cost crisis. Of the total of national health spending, only about one fifth goes to pay physicians. That amount is cut roughly in half by practice expenses such as malpractice insurance. 

And personally, if I needed, say, an artificial hip, I wouldn't want the surgeon implanting it to be worried about paying his bills during the operation. 

Brian Buntz is the editor-at-large at UBM Canon's medical group. Follow him on Twitter at @brian_buntz.