<p>I have heard numerous complaints from physicians. Moan and groan, it’s just not worth it. The malepractice insurance costs too much, etc, etc. </p>
<p>Well it is all relative. I worked and worked and barely made a fraction of a physician’s income. Most of the docs I know make several million a year — o yes minus the maximum of $75k for insurance. sob. sob.</p>
<p>^^ Give me a break. Don’t lump the whole profession together just because you happen to know a few jerks. I don’t know where you live, but H has been a physician for 26 years and I don’t know any doctors who make that kind of money, or even close to that kind of money. I also suspect you don’t really know these doctors’ finances, unless you happen to be their accountant…if that’s the case, charge them more.</p>
<p>Really, edad? That must be quite an affluent area. I know scores of physicians and only one makes “several million a year” - a fertility specialist who owns his own lab and is entrepreneurial in other ways. The other extremely well-paid MD is a pediatric cardiac surgeon who makes nearly $1 million but performs complex surgeries in hospitals 90 miles apart. A decade of training, a staggering workload, and crazy stress - I’d say he’s fairly paid. And highly trained surgeons in risky specialties don’t grow on trees - they’re going to be well compensated.</p>
<p>My husband is deeply unhappy about the state of medicine today, but his earnings (not to share too much, but less than the average for his specialty posted earlier in this thread) have little to do with his dissatisfaction. He’s found that being an MD today isn’t what he thought it would be as he was training 30 years ago. He still enjoys patient care, but, since he and his colleagues are under so many financial, regulatory, and insurance constraints, there’s nowhere near as much satisfaction in it as there was when he began. I am worried about his health and hope every day that we can find a way for him to retire before 65.</p>
<p>i’m joining the chorus of give me a break!! no doctors around here making millions per year, or even one million!! frazzled, your H and mine sound the same…unfortunately, mine is 67 and still sees no way to retire yet. I spent the day yesterday on the phone with insurance companies…change in cpt codes for a test we do, however the insurance companies have not “updated” their edit codes…so all claims have been denied… their answer…welll just hold all your claims and check back with me in a month, hopefully we will have updated them by then… you coded it right, its just that its new!. (rant/vent over)</p>
<p>Millions, highly doubtful…</p>
<p>I only know of 1 doctor personally who makes 1 million or more a year and they have an endowed chair at HMC, written books and lecture around the world.</p>
<p>Also blowing the BS whistle on the “making millions” line. Ridiculous.</p>
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<p>Yep, my MA spent 2 1/2 hours on the phone for 2 prior authorizations (meds that aren’t covered by insurance but if x,y, and z was tried they’ll consider it). Insurance companies tell patients “all your doctor has to do is call us.” They don’t tell them that we can spend hours on the phone and they still may not get their med covered. This is UNPAID time that could be used taking care of patients and I get complaints that I charged x for only y amount of face time. This is why I’m getting out of the private practice business. Why the burden can’t be put on the patients, I don’t know. </p>
<p>(warning, rant is not over and may be reactivated at any time)</p>
<p>LOL gtalum… maybe we need a rant thread for insurance,precert etc stupidity. I just loved their answer yesterday…just dont get paid for a month…then check if we fixed it yet</p>
<p>thought i would give a little education here… this is our regions insurance reimbursement. Dr’s didnt come up with the bright idea of there being 5 levels of service for office visits…but we are stuck with it. Although it is NOT time based (rather based on complexity of problem, data collected/reviewed, history, physical etc) there is a presumed time spent component</p>
<p>a level 2 (brief visit) 38.00
level 3 (moderate) 64
level 4 (more comprehensive…and assumed to be about 45 minutes face to face) 96</p>
<p>depending on the dr specialty (and visits are paid the same fee for a gp or a specialist) , is how many you can see in an hour. My H has rather complex patients and can see about 2-3 per hour… now tell me how you make millions! and dont forget to deduct the cost of your office, staff, malpractice, supplies, insurances, utilities, etc etc</p>
<p>what i think is ridiculous also… is that many people have copays of 40-50 (more than the insurance even pays for a low level visit)…we give out refunds.</p>
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<p>My partner and I joke all the time that being BC/BS employees have the easiest job in the world as all you have to do is stamp “deny” on the insurance claims. BTW, we don’t get paid to resubmit our claims after being denied either. As parent56 said, they don’t care if we get paid several months later. </p>
<p>I do know of a primary care physician who is making a million (self declared when talking to med students). He has an interesting business model in that he does not deal with insurance companies but charges low ($45 last I checked) fees for office visits. Supplemental income is made by negotiating a low rate for labs (who inflates prices many times what it costs) and charging the patient a bit more. Again, cash only. Overhead is lower as he does not deal with insurance companies. </p>
<p>If we are serious about health reform, it’s what all primary care medical practices would look like and people would buy insurance for catastrophic illnesses only. It won’t happen as politicians are being paid for by insurance companies.</p>
<p>Edited to add a link <a href=“http://prosites-bforrest.homestead.com/[/url]”>Website Disabled; and he has raised his rates to $56 per visit. His quality of care numbers are also excellent.</p>
<p>… yet there is so much resistance to changing the U.S. system, which no developed country adopts, AFAIK.</p>
<p>gtalum… wish that would work here…however the insurance demographic/type of specialty wouldnt let it be feasible for us…about 60% care (H refuses to consider making elderly/ill patients pay out of pocket…they worked for years to have this benefit, and i agree), bc has monopoly on the privates and every doctor here accepts it (so patients would just go elsewhere), caid patients couldnt pay.</p>
<p>Actually vonlost, there is resistance to socialized medicine and few are willing to look outside the box at entrepreneurial models like the one I linked to. One of the reasons is because insurance companies, and therefore politicians, don’t want us to know. Also, people are so used to insurance “entitlements” that they’re afraid to take and aspirin without permission from insurance.</p>
<p>I agree parent56, several of our patients would stick with us but several would go elsewhere because we stopped accepting their insurance. But, medicare could reform it’s system such that patients would not “lose” what they worked for.</p>
<p>Gtatum…in your previous example, don’t you have to buy an access card?</p>
<p>No dstark, the Access card would be for those who can anticipate being a heavy user of primary care and can get unlimited visits for $436. Those who need to see the primary care provider on occasion would pay the $56/office visit.</p>
<p>i think if you opt out of care now, the patient also has to agree to NOT file, in the required private contract. have never figured out though, how you could do that with hospital visits etc, those patients would not have agreed to do that</p>
<p>Ok. Thanks. I wonder how much my health insurance premiums are used for primary care.</p>
<p>If I go to the doctor you mentioned…and then he recommends that I see a cardiologist…</p>
<p>then I am back in the insurance cesspool when I do visit the cardiologist?</p>
<p>I can see why family doctors would want out of the insurance game…and patients would probably benefit…but patients would still be stuck in the insurance game if they had to see a doctor outside of family practice?</p>
<p>Parent56- Insurance would not be involved for any primary care and have a high deductible insurance for non primary care illnesses. </p>
<p>dstark - He has negotiated good rates for his patients with local specialists, including the cardiologist. Also, the patient would have catastrophic insurance (5-10K deductible) for expensive illnesses. Yes, the patient would be back in the insurance game for specialist visit, but that should comprise fewer visits for the population as a whole.</p>
<p>ahhh, as H is specialist, he is called in to “consult” (in quotes as medicare in its wisdom now says there is no such thing as a consult…its just a visit)…H said, “oh that would work…you just follow me around with private contracts into the icu…sign here please before the doctor can see you…cant have you filing your insurance”… if it wasnt so crazy, it might be funny.</p>
<p>will add to that…we get rejected claims all the time now as the patient will also see the attending the same day, we us now use the same code…insurance wont pay for the same service twice on same day. (attending is supposed to put a modifier on theirs but they dont) … according to insurance…i am supposed to call the attending to get it straightened out… not happening… for once though care is on top of this one, it is the other insurances that cant seem to get it figured out</p>
<p>geez i feel better now LOL. again will add though, that it is the patients that make it all worth while…the lifestyle can be crazy with long hours and insurance regs etc… but if you are in it for the right reasons…you will still find reasons to smile, rejoice and sadly sometimes see your H cry with a patient family, that nothing could help</p>