IWETHEY v. 0.3.0 | TODO
1,095 registered users | 0 active users | 0 LpH | Statistics
Login | Create New User
IWETHEY Banner

Welcome to IWETHEY!

New Most physicians aren't sole proprietors.
http://www.bls.gov/oco/ocos074.htm

Physicians and surgeons held about 661,400 jobs in 2008; approximately 12 percent were self-employed. About 53 percent of wage–and-salary physicians and surgeons worked in offices of physicians, and 19 percent were employed by hospitals. Others practiced in Federal, State, and local governments, educational services, and outpatient care centers.

According to 2007 data from the American Medical Association (AMA), 32 percent of physicians in patient care were in primary care, but not in a subspecialty of primary care.


Are they worried about billing issues? They don't seem to be on the whole: http://www.nejmjobs....ation-trends.aspx (from 2007):

Physicians heading into the job market for the first time or eyeing a career move in 2007 will find plentiful opportunities and attractive compensation packages regardless of their specialty or preferred setting. Demand for specialists and primary care physicians is high in many regions, especially in non-urban areas. That demand is translating into substantial signing bonuses, generous education loan repayment, and other competitive benefits — especially among large groups and health systems.

[...]

The employment picture is bright across the board. Even primary care, in which flat incomes and reimbursement produced a challenging practice environment in the recent past, is experiencing gains. Incomes for family practice physicians, internists, and pediatricians increased in 2005 and 2006, and the Centers for Medicare and Medicaid Services recently modified the Resource Based Relative Value Scale to attach a higher relative value unit (a measure of the physician work component) to most office-consultation services. The latter will increase Medicare reimbursement to most primary care physicians, industry experts concur.

[...]

As the health care-delivery landscape changes, so do physician-compensation systems and practice models. For example, as costs increase and concerns about cost-effective care intensify, annual bonuses are undergoing modification. Community practice bonuses have typically been based on collections. Yet increasingly, they are being based on RVUs, the recruiting firms report. Quality-based bonuses — particularly for improved management of chronic conditions — are also on the rise. At Kaiser’s TPMG, for example, physicians can earn up to 10 percent of their annual salary in an incentive payment that is based half on quality and half on service (measured by patient satisfaction).

[...]


Doesn't sound so bad to me.

If the median income for a GP in 2008 was $157k+ http://www.bls.gov/o...ent/oes291062.htm , then they're obviously bringing in a lot more than that into their practice.

They're not eating off the dollar menu...

HTH.

Cheers,
Scott.
New And how much of that is by necessity?
where the old style "family doctor" model simply cannot be sustained any longer based on the math I've already posted.

Also, most of your info is 2007 based on older studies. Medicare/Medicaid has been cut again since then...

And you notice in the articles that the providers had to game the system to get doc content back up to have the reimbursement levels (then) sustainable.
----------

Add to this, that this is current system with private insurance out there as the offset. While the current change leaves this model in place, it is clearly not "desirable" by many...preferring to tell us that a single payer government system is better (just look at Medicare)...when that model currently (left to itself) is unsustainable.

------------

Can it be done...probably.

Can >we< do it?

------------

And aren't we getting into another "i don't feel bad for them cause they make more than I do" discussion?

I will choose a path that's clear. I will choose freewill.
New No, that's not it.
You're supposing an awful lot about his business without a lot of information...

It's not that "I don't feel bad for them because they make so much." It's "I don't feel bad for them because the evidence is that, on average, they're not telling the truth."

I went to graduate school with a fellow from Iran. Over there, the people at the top of the professions are engineers and architects - not physicians. There is no intrinsic reason why physicians should be on top of the professions over here.

Nobody is immune from the blessings and curses of the economy. We spend vastly more for medical care than other countries - at least partially due to inflated compensation for physicians. It seems to me that it's silly to expect that the rate of increase in average physician compensation isn't going to decline at least until things are back in something approaching balance. Of course, physicians are going to lobby against it, but I don't think they'll win for very long.

Yes, that data is from 2007 and 2008. You're welcome to post later averages if you think they've changed greatly.

Oh, one more thing. http://www.aap.org/r...rch/readfirst.htm

Fees shown in this report series represent fee-for-service (FFS) payments reported by states for state-administered Medicaid programs only. Nationally, the majority of children enrolled in Medicaid programs are enrolled in managed care plans, which may or may not benchmark provider payment rates to fees shown in this report. In fact, payment levels are known to vary widely between state-administered plans and managed care plans in some states. As examples, some of New York State's Medicaid managed care plans reportedly pay substantially higher than its state-administered FFS plan, whereas the opposite has been observed in Hawaii.


IOW, "Medicaid only pays $25 for office visits!111" is not enough information to draw any conclusion about the state of his business or (obviously) the state of the medical profession.

FWIW.

Cheers,
Scott.
New Not really
I'm doing simple math based on info on 3 major expense categories to run a single doc practice...which, if riches were to be had, should provide a good living.

The profession has evolved into patient mills...and gee, you think there could be a reason for this?

So you throw out the averages...and since the average doc pulls down 150 per year on their education investment...all must be right with the world...and heavens, we're so backward that we think doctors are important and might deserve compensation.

Not disputing that we pay more. What, though, do we really pay more for? Only 20 cents on the dollar for healthcare goes to doctors.

In 2000, (and I can't imagine it being much better now) the cost of overhead (and who, I wonder, designed the payment system) was 31% http://www.pnhp.org/...ons/nejmadmin.pdf

Part of that overhead will eat into the docs 20% take, as well.

So, maybe you are taking it out on the wrong people.

(Nah, can't be. They have a nicer car than you. )

I will choose a path that's clear. I will choose freewill.
New Regardless
To lay an employee off for voting "wrong" is out of order.

Even if one is not making as much money as one deserves.

---------------------------------------
Why, yes, I did give up something for lent. I gave up making sense.
New Agree
and pretty much said so in the first post
I will choose a path that's clear. I will choose freewill.
     Doc targets Obama voters for layoffs in advance of Obamacare - (lincoln) - (38)
         Maybe you can do that in Texas . . . - (Andrew Grygus)
         there's an update at the end - (SpiceWare) - (36)
             Here's the next update - (mhuber) - (34)
                 And the next.. - (beepster) - (33)
                     Where? - (jake123) - (32)
                         plumbers rates for a home visit vary from $65 to name brand - (boxley) - (1)
                             Master plumbers up here - (jake123)
                         Re: Where? - (beepster) - (29)
                             What, lawyers don't have to by malpractice insurance? - (jake123) - (11)
                                 Thats to break even. - (beepster) - (10)
                                     Dude, you don't seem to understand something - (jake123) - (3)
                                         ..and it is Our Nature to Fight that Fact with every Disney - (Ashton) - (1)
                                             would you care - (beepster)
                                         Don't I? - (beepster)
                                     Most physicians aren't sole proprietors. - (Another Scott) - (5)
                                         And how much of that is by necessity? - (beepster) - (4)
                                             No, that's not it. - (Another Scott) - (3)
                                                 Not really - (beepster) - (2)
                                                     Regardless - (mhuber) - (1)
                                                         Agree - (beepster)
                             I suspect someone's giving worst case numbers... - (Another Scott) - (15)
                                 I don't need to read the numbers. - (Andrew Grygus) - (14)
                                     Quod Erat.. oh, you know.. - (Ashton) - (9)
                                         To each.. - (beepster) - (8)
                                             And without a soupçon of *Society Maintenance by Each - (Ashton) - (7)
                                                 Ah, I see... - (beepster) - (6)
                                                     As Peter Geyl observes, - (Ashton) - (5)
                                                         could you point to some place in - (beepster) - (4)
                                                             The problem with the Reactionary view is apparent: - (Ashton) - (3)
                                                                 Thanks for clearing that up - (beepster) - (2)
                                                                     Well, perhaps even, you could.. think outside The Box? too -NT - (Ashton) - (1)
                                                                         I could..and often do... - (beepster)
                                     And all those beemers - (beepster) - (3)
                                         Lots of Beemers in East LA - (Andrew Grygus) - (2)
                                             enterprising young men they are! - (beepster) - (1)
                                                 snort! -NT - (boxley)
                             Same tired argument that - (Ashton)
             Re: there's an update at the end - (lincoln)

Those chicken wings are really spicy! Don't eat those!
198 ms