DB talks about the lack of outpatient internists. “The concept of our reimbursement system is bankrupt. If you pay me for a unit of care, regardless of how much time I spend, I will look for ways to decrease the time of that unit of care. If I can see 7 patients in 2 hours rather than 6, I have increased my gross income by 17%, without significantly changing my overhead! But I also had to decrease each patient visit by approximately 3 minutes.”

I’m an outpatient internist. These words ring true.

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  • dr john

    The insurance companies that hold near-monopolies in the various states will not increase our reimbursements. They will rely on FMG’s, PAs, and on the new generation of “lifestyle doctors” who don’t see themselves as the main breadwinners for their families.
    Perhaps big hospital chains may employ us as loss-leaders for their other, better psying services.
    But basically, we’re screwed.

  • Anonymous

    Somewhat like a batting average or era, an ER docs vital employment statistic is his/hers pph (patients per hour) tempered by their lph (lawsuit per year) and Hospital Administrations pss (patient satisfaction score).

    A high pph is needed because every third patient does not pay at all — a strike out. Medicaid will only pay the rate of a base hit and all other insurers automatically subtract a base.

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