The doctor is traditionally seen as a prominent figure, a high society type donning a white… The doctor is traditionally seen as a prominent figure, a high society type donning a white coat, sporting a stethoscope across the shoulder and — do not forget — jingling the keys to his Bentley as he strolls out of the hospital. That man is living.

But, more often, that man is a stereotype. Few specialties afford a doctor that life, and recent events prove that window is closing for all doctors.

Last night, the House of Representatives approved the Senate version of President Barack Obama’s health care overhaul, with a reconciliation package pending.

The health care bill and a 2002-enacted law will change the future of the physician profession irrevocably. Two major items concern doctors, Medicare payments and tort reform. One thing is sure: Premedical and medical students will need to decide if this reality is what they thought it would be.

For primary care physicians, the health care bill is a blessing because it includes an increase in Medicare payments to this field specifically. However, other specialties will not benefit from this and in fact will face a 21 percent cut in Medicare payments from the separate 2002 law, the postponement of which will end soon.

Regardless of the advantage primary care physicians will receive, a majority of physicians still face real payment cuts and all face the same malpractice insurance they’ve been paying, from lack of tort reform.

Tort is a negligent or intentional civil wrong not arising out of a contract or statute. The act injures a person in a way that allows him or her to seek compensation of some sort for it. In medicine, these legal injuries are a gray area, and patients can bring their grievances to the court. Doctors pay malpractice insurance to cover such legal expenses. It’s a literal cut in their salary.

Doctors make good money — gross income that is. The average physician salary across different fields in the U.S. ranges from $122,603 to $255,343 in more lucrative fields, according to payscale.com. Still, all doctors need to see tort reform, and some non-primary care doctors could not handle a 21 percent payment cut.

To put these numbers in perspective, the average debt of medical graduates of 2009 was $156,456, according to the American Medical Association. Tuition has increased a daunting 50 percent from 1984 to 2004, not followed by a similar trend in salary. Doctors also pay hefty malpractice insurance. Therefore, the gross income a specialty is tagged with is not all it seems. Consequently, malpractice is a relatively major expense.

In an interview with The Saratogian, U.S. Rep. Scott Murphy, D-Glens Falls, N.Y., said, “One thing we didn’t do nearly enough on is tort reform. This bill makes small steps toward tort reform, but they are not enough” in regard to the bill.

The Harvard School of Public Health recently found that 40 percent of malparactice suits are without merit, in the U.S. These frivolous cases cost Americans billions of dollars annually. Additionally, the Massachusetts Medical Society found that 83 percent of its doctors order unnecessary, expensive tests and procedures in fear of bad medical practice and the lawsuits and insurance hikes that would promptly follow. Not only is malpractice an excessive expense to doctors, but to the public in general.

There is no health care reform without tort reform, but the House is undeterred. Universal health care and removal of discrimination against patients with pre-existing conditions sounds dandy on paper. But the doctors need to be tended to as well. Congress should reconsider payment cuts, and the health care bill should be made to reflect the vital need for tort reform, for doctors and for Americans.

A doctor, especially in a less specialized field, is not asking to live the high life. He just wants to make living with his profession a sound choice.

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