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Wednesday, August 30, 2006Ideally, the hourly rate would not be the same for all primary care physicians, but would be assessed on a sliding scale, predicated on a doctor’s level of education. Internists and pediatricians — the primary care doctors who have had the most training — would receive a higher rate than general practitioners and family physicians would. Say what, Mr. Dr. Cook? Internists train for three years, yes three years. Pediatricians train for three years. How many years do family physicians train? Why, three. How is it that we are less educated than the others? One could argue that family physicians are more broadly educated, but not less educated. Some of his op-ed is a little over-dramatic regarding the pressures on a busy physician: He rises at 4 a.m. to make a dent in his avalanche of paperwork before dashing off to make rounds at the hospital and arrive at his office before 8. For the next 10 to 11 hours, he races through a series of patients so long, he cannot talk to any one of them as much as he believes he should, and he constantly worries he’ll miss something. Maybe his friend really does get up at 4AM to do paperwork and spend all of his time in his office from 8AM to 7PM seeing patients. If he does, he should be making lots and lots of money. Specialist money. Personally, I find it hard to believe. He doesn't have to work that hard to make a decent living unless his patient population is entirely Medicaid. Still, I wouldn't mind getting paid by the minute. That would mean I could have charged for that 40 minute phone call with a family member last night. It was not an efficient 40 minutes, but I bet it would have been if they'd been paying me for it. UPDATE: In the comments, Dinosaur points out another error in the op-ed: You're right about the FP nonsense, but didn't you read the rest of it? He (Cook) claims that primaries are currently receiving a flat fee of just over $50 (from both Medicare and private payers) for every patient they see regardless of what's wrong with them. That's ridiculous! Where on earth does he come up with such an outrageous statement?? Oh yeah; he writes fiction. In my area, the average visit is $50 from Medicare, but that's for a rather straight forward problem. For the more complex problems - multiple chornic illnesses, new illness that requires an extensive work-up- the payment is higher. (About $71). Reimbursement varies from area to area, however, and perhaps in Naples, Florida, it is closer to $50 for even the more complex cases. Since I don't work in Florida, I don't know. posted by Sydney on 8/30/2006 09:54:00 PM 2 comments 2 Comments:
You're right about the FP nonsense, but didn't you read the rest of it?
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It's not the absolute amount; it's the idea that we're being paid a flat rate,
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