Medicine is a business, and physicians have to learn to deal with it:

As vice president of my wife’s medical practice, I must defend practice management consultant David Scroggins. His assessment of physician productivity in “Secret weapons for a successful practice” [Oct. 7, 2005] is correct. If we don’t meet our financial goals and pay our fiscal obligations, we shut our doors.

The business of medicine requires planning, discipline, and performance. It means hitting the numbers: keeping expenses low, production high, and growing the business. Imagine your practice is a sealed room filling with water. The ceiling symbolizes your Medicare, Medicaid, and insurance reimbursement rates. The rising water represents your business expenses. Now imagine the ceiling being lowered. No matter how good a swimmer you are, at some point you run out of air.

To keep our practice breathing, our physician averages 30 patient encounters per day (about 8,000 per year) and our midlevels average 20. As a rough yardstick, that means a minimum of $3,500 per day””our goal is $4,000 per day.

What does that imply about quality? Nothing. It’s not an either/or proposition. And my wife still derives satisfaction from her profession.

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