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Responses to Comments, Part II
As per "the almighty dollar" comment: Your anger is directed to the wrong party. It is not the doctor who is consumed with the dollar but the greedy insurance companies. As a point, in my office, the 5 major insurance companies that I accept owe me hundreds of thousands of dollars for services rendered. I saw the patient. The patient was treated with compassion and expertise.
Shouldn't your insurance company pay the bill? They often do not and have many tricks to delay payments.
Doctor's offices have bills to pay and malpractice etc. Aren't doctors entitled to get paid by the insurance company on a timely basis especially since you as the patient paid a lot money to THEM for an insurance plan that the doctor is a part of?
As far as the Waiting no More than 30 Minutes in an office comment attached to the "doctors schedule 15 minutes apart to make money comment":
I do not know why you made up 30 minutes, why not 15, why not 45. The reality is that dependent upon the day I can schedule an office day with all intentions of being on time and the first patient comes to me with cancer in the pelvis and I have to discuss complete removal of half of the pelvis. This is not a 15 minute visit and can even be a 1 hour discussion.
The patient traveled 3 hours to see me. Do I tell them to come back? No. Do I discuss them and give them full attention. Yes.
If I scheduled only 2 patients an hour, after this first patient, I am already 30 minutes behind. Following that a child comes in with a fracture that takes an hour to reduce. Now I am starting 1 hour behind. This is not an excuse but reality. You can see how this can happen.
It does bring up the point- are you entitled to be seen in a reasonable amount of time or is it an expectation?
In my practice I NEVER leave a room until ALL questions are answered. In the last year we did a study of my patient hours. The average wait time was longer than your 30 minutes. In all the patient visits, 12 patients left due to the time.
Once they are in the room they get 100% from me for as long as they need. I always apologize to a patient for being late and often tell them exactly why- for example the pelvis tumor. Patients who arrive to the office are told the current wait time and are offered to reschedule if that is too much.
When I get in the room I give them my heart and my soul. That is what they are ENTITLED to in my practice. It has been also what they have learned to EXPECT. Complete attention to their problem. Do I please all the patients? No way.
On the money issue- Neurosurgery doctors pay over $130,000 in malpractice, over $100,000 in rent/supplies, over $250,000 in personnel to support the practice and $50,000 in associated expenses.
United Health Care pays about $80.00 for a visit. Assuming you saw the 10 patients a day that you want them to see that would be $800.00 a day. They do office hours 4 days a week and operate 1. That is $3200.00 a week in office hour billing. In 50 weeks a year that is $160,000 a year. If they do 3 laminectomies (spine operations) a week (which is all they would get at 8 patients a day) all in Medicare and Managed Care they were reimbursement is $2500.00 per operation. This would be at 50 weeks a year $375,000 a year. Added up- gross revenue is $535,000. Expenses are $530,000. This leaves $5,0000 a year as take home salary.
This is based on your assumption that:
The numbers don't add up. Your energy should be at TORT REFORM and INSURANCE REFORM.
Try this idea:
This piggybacks on to looselink's interesting comment:
"I recently met a doctor who told me she was a concierge doctor. She said she got really tired of the 15 minute in and out office visit. she limits her practice to 300 patients per year; all of whom pay her $1200 up front in order to get instant appointments, phone calls returned and even house visits if necessary. I'm not sure how I feel about that! It is a rather elitist concept, but she claims that she is able to provide much better medical care for fewer patients this way."
Is this what people want? Some do. Some do not. Replacing your roof costs $15,000 to $30,000. How much should replacing a hip cost? You tell me.
In answer to meloh's following comment:
"You see, sir, I have been waiting by my loved one's bedside for 10 hours today, hoping you would drop by for a hospital visit which will take you maybe 5 minutes and for which you will be paid $300."
You may have been waiting 10 hours by your family member's bedside. Most probably your doctor has a schedule of when to see the patient. You should find out that schedule. As for the 5 minutes - that is a ridiculous generalization. I have spent between 5 minutes (on a very non-complicated case) to 30 minutes depending on what the patient needs.
As far as the $300.00 for the hospital visit - there is the problem. People like you think that the average doctor is making millions in the practice. Untrue. Average pediatricians make about $120,000 a year. Surprised? Also, for the record, a hospital office visit from Medicare pays approximately $32.00. You should get your facts rights before you make such generalizations.
As per the most disgusted poster, so self-named as "disgusted101":
I will refer to a rheumatologist, neurologist, and often another Orthopaedic Surgeon as I tell the patient, another perspective may help here. If your doctors are not doing that, change doctors. Additionally you seem to think that doctors get paid for compassion. That is not true. They get paid to render a service to help you with your disease.
A good doctor adds to that service compassion and care. That is what separates that doctor as an exceptional one. When I show compassion to my patients it is not because I am getting paid for compassion it is because that is how I practice. There are non-compassionate doctors who have remarkable surgical skill. They too have a role in medicine.
If there is a Neurosurgeon who if the world's best at saving a patient's life who has a bleeding blood vessel in the brain but is not compassionate, this is a valuable person in society. Just as not all teachers have the same total qualities as others and not all in the clergy have the same as their colleagues there will be a wide range of qualities in medicine as well. To expect ALL physicians to be exactly the same is unreasonable.
In conclusion I would like to thank "anonymous":
Keep the discussion coming!
Dr. K.
Related Topics: Does Pain Keep You Up? Test Your Sleep IQ, The Emotional and Economic Costs of Pain
Technorati Tags: healthcare, medicalpractice, entitlement, expectation
Shouldn't your insurance company pay the bill? They often do not and have many tricks to delay payments.
Doctor's offices have bills to pay and malpractice etc. Aren't doctors entitled to get paid by the insurance company on a timely basis especially since you as the patient paid a lot money to THEM for an insurance plan that the doctor is a part of?
As far as the Waiting no More than 30 Minutes in an office comment attached to the "doctors schedule 15 minutes apart to make money comment":
I do not know why you made up 30 minutes, why not 15, why not 45. The reality is that dependent upon the day I can schedule an office day with all intentions of being on time and the first patient comes to me with cancer in the pelvis and I have to discuss complete removal of half of the pelvis. This is not a 15 minute visit and can even be a 1 hour discussion.
The patient traveled 3 hours to see me. Do I tell them to come back? No. Do I discuss them and give them full attention. Yes.
If I scheduled only 2 patients an hour, after this first patient, I am already 30 minutes behind. Following that a child comes in with a fracture that takes an hour to reduce. Now I am starting 1 hour behind. This is not an excuse but reality. You can see how this can happen.
It does bring up the point- are you entitled to be seen in a reasonable amount of time or is it an expectation?
In my practice I NEVER leave a room until ALL questions are answered. In the last year we did a study of my patient hours. The average wait time was longer than your 30 minutes. In all the patient visits, 12 patients left due to the time.
Once they are in the room they get 100% from me for as long as they need. I always apologize to a patient for being late and often tell them exactly why- for example the pelvis tumor. Patients who arrive to the office are told the current wait time and are offered to reschedule if that is too much.
When I get in the room I give them my heart and my soul. That is what they are ENTITLED to in my practice. It has been also what they have learned to EXPECT. Complete attention to their problem. Do I please all the patients? No way.
On the money issue- Neurosurgery doctors pay over $130,000 in malpractice, over $100,000 in rent/supplies, over $250,000 in personnel to support the practice and $50,000 in associated expenses.
United Health Care pays about $80.00 for a visit. Assuming you saw the 10 patients a day that you want them to see that would be $800.00 a day. They do office hours 4 days a week and operate 1. That is $3200.00 a week in office hour billing. In 50 weeks a year that is $160,000 a year. If they do 3 laminectomies (spine operations) a week (which is all they would get at 8 patients a day) all in Medicare and Managed Care they were reimbursement is $2500.00 per operation. This would be at 50 weeks a year $375,000 a year. Added up- gross revenue is $535,000. Expenses are $530,000. This leaves $5,0000 a year as take home salary.
This is based on your assumption that:
- Doctors should see one patient an hour
- Doctors should accept the payment of all healthcare or managed care
The numbers don't add up. Your energy should be at TORT REFORM and INSURANCE REFORM.
Try this idea:
- The government should pay all malpractice insurance premiums if the doctor accepts insurance plans
- The insurance companies charge less money each year for premiums if they make whopping profits the year before.
This piggybacks on to looselink's interesting comment:
"I recently met a doctor who told me she was a concierge doctor. She said she got really tired of the 15 minute in and out office visit. she limits her practice to 300 patients per year; all of whom pay her $1200 up front in order to get instant appointments, phone calls returned and even house visits if necessary. I'm not sure how I feel about that! It is a rather elitist concept, but she claims that she is able to provide much better medical care for fewer patients this way."
Is this what people want? Some do. Some do not. Replacing your roof costs $15,000 to $30,000. How much should replacing a hip cost? You tell me.
In answer to meloh's following comment:
"You see, sir, I have been waiting by my loved one's bedside for 10 hours today, hoping you would drop by for a hospital visit which will take you maybe 5 minutes and for which you will be paid $300."
You may have been waiting 10 hours by your family member's bedside. Most probably your doctor has a schedule of when to see the patient. You should find out that schedule. As for the 5 minutes - that is a ridiculous generalization. I have spent between 5 minutes (on a very non-complicated case) to 30 minutes depending on what the patient needs.
As far as the $300.00 for the hospital visit - there is the problem. People like you think that the average doctor is making millions in the practice. Untrue. Average pediatricians make about $120,000 a year. Surprised? Also, for the record, a hospital office visit from Medicare pays approximately $32.00. You should get your facts rights before you make such generalizations.
As per the most disgusted poster, so self-named as "disgusted101":
Most physicians I know will often tell a patient when appropriate that they SIMPLY HAVE NO IDEA and send out to another physician. I do that whenever it is needed- often 2-3 times a week.
"It would also be nice to hear a physician be HONEST from time to time when they SIMPLY HAVE NO IDEA, then say I HAVE NO IDEA and send us to someone who may be more qualified, HOWEVER doing this shows they arent all they would like us to believe they are.
GET OFF THE HIGH HORSE AND BRING BACK THE COMPASSION THAT YOU ARE BEING PAID FOR is exactly what I would like to tell most physicians."
I will refer to a rheumatologist, neurologist, and often another Orthopaedic Surgeon as I tell the patient, another perspective may help here. If your doctors are not doing that, change doctors. Additionally you seem to think that doctors get paid for compassion. That is not true. They get paid to render a service to help you with your disease.
A good doctor adds to that service compassion and care. That is what separates that doctor as an exceptional one. When I show compassion to my patients it is not because I am getting paid for compassion it is because that is how I practice. There are non-compassionate doctors who have remarkable surgical skill. They too have a role in medicine.
If there is a Neurosurgeon who if the world's best at saving a patient's life who has a bleeding blood vessel in the brain but is not compassionate, this is a valuable person in society. Just as not all teachers have the same total qualities as others and not all in the clergy have the same as their colleagues there will be a wide range of qualities in medicine as well. To expect ALL physicians to be exactly the same is unreasonable.
In conclusion I would like to thank "anonymous":
Though perhaps a little rough around the edges, the doctor's answer strikes me as basically correct. The covenant relationship between doctor and patient entitles the patient to the best care within the doctor's capability and to conscientious and respectful treatment and service. In actual practice, the latter entails that I am I entitled to your conscientious effort to see me on time and to give me your full attention when you do. But it would be madness to insist that my rights are somehow being violated if the reason I am being kept waiting is your conscientious treatment of another patient.
Keep the discussion coming!
Dr. K.
Related Topics: Does Pain Keep You Up? Test Your Sleep IQ, The Emotional and Economic Costs of Pain
Technorati Tags: healthcare, medicalpractice, entitlement, expectation
