I had a specialist tell me today before we (hospitalists) came along and before they hired PA's as their "extenders" that he got 47 pages in a 1/2 day of work. Guess how many of those are reimbursed. Zero. 47 pages. And you can't collect for a single one of them. Unbelievable. So the next time you have to wait for your doctor, realize they are doing free work all day long, everyday and you are just the next one in line. You get what you pay for.
I spent an entire hour today teaching a family about post operative MI. I drew pictures, answered questions about everything.
With my training, expertise and education, I should be able to collect at least $250/hour. I'm pretty sure medicare will pay me less than $75. After overhead I make less than a massage therapist for an hour of teaching. Family's happy but I can guarantee you that if I sent them a bill for the other $175, they would be furious. My time should be free, right? It's your right, right? Is your time free?
Witness the collapse of cognitive medicine before our eyes.
I spent an entire hour today teaching a family about post operative MI. I drew pictures, answered questions about everything.
With my training, expertise and education, I should be able to collect at least $250/hour. I'm pretty sure medicare will pay me less than $75. After overhead I make less than a massage therapist for an hour of teaching. Family's happy but I can guarantee you that if I sent them a bill for the other $175, they would be furious. My time should be free, right? It's your right, right? Is your time free?
Witness the collapse of cognitive medicine before our eyes.
Hi Doc,
ReplyDeleteI just read your post over at Health Beat about the Mass HC "experiment" and I couldn't agree more. I've been preaching the same basic "cash only" primary care system for years. Its too bad most of those years were during med-school were i was criticized for embracing the free market. I look fwd to ending residency and starting my own private cash practice to demonstrate the effectiveness of free market physicians.
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Doctors are not servants of their patients, they are traders like everyone else in a free society and they should bear that title proudly considering the crucial importance of the services they offer. -- Ayn Rand (1905-1982)
Agreed this is a horrible state of affairs. Medicare is really taking advantage of our physician population by not paying for needed services, while not allowing patients to pay for these themselves. Economics may it pretty clear that all non-reimbursed services will eventually stop.
ReplyDeleteWhat is crazy is that phjysicians are killing themselves (and their incomes) to provide services that are completely unreimbursed.
As more like JoshMD move over to the cash world, the current system will rightfully fall apart and the tooth fairy economics of the current system will go back to the land of wishful thinking.