By going retail: “I really didn’t spend 12 years in school to sell glasses, but that’s half our income right now.”
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This is so true. I have a friend who is an ophthalmologist. He is older and does not do surgery, but his sole source of income is from glasses sales. The optical shop does not accept medicare or medicaid. His revenue from office visits only pays his overhead; there is no profit, and he would be forced to retire if he did not have an optical shop. I think it is so ironic that optometrists want to expand their scope of practice when the money is all in glasses sales!
USA is still having a good economy despite the war and all that .if the payments are linked with the growth how it is being cut? Can anybody please explain ?
Physician reimbusement and health care expenditures are two different things. Federal health care dollars go to pay hospitals, home health, drug costs, wheelchair manufactureres,HMO’s, and providers amongst others. It is a zero-sum game with an increasing pool of benficiaries. Therefore, when drug costs rise, or there are more patients needing care, physician reimbursements must fall. Do you know that from September 22-30 the federal government will not be paying doctors? I think it is time to take a weeklong vacation, but that is exactly what the government and insurers would like us to do. Meanwhile rents, staff salaries, insurance costs, etc. continue to rise for the health care provider. Because you cannot balance bill, you cannot pass on the increasing costs nor compensate for decreasing reimbusement. Because of the structural rigidity inherent in a medical career, you are essentially stuck. It will take a crisis, which is where we are heading, before this will be worked out.
Ophthalmology is becoming a pretty tired cow that CMS has been milking for cost shifting many years now. Cataract surgery reimbursement has been a very attractive source of reduction since it is the most commonly performed major surgery in the USA, by a large margin. Yet today, when the actual dollars paid for a cataract operation is less than the amount paid in 1967 when Medicare part B was established, Medicare intends to carry out a succession of cuts over the next several years that will further reduce the reimbursement by another 20%. Meanwhile, the material support for cataract surgery has become increasingly expensive. Cataract surgeons are now adding enhanced options in implant lens choices which are not covered by Medicare as a way of increasing the revenue and offsetting reimbursement cuts. Cosmetic surgery procedures and skin rejuvenation, Botox and Restylane injection and other procedures are being added in many practices to offset the declining revenue from the traditional medical and surgical practice.
One might notice how the sob story article failed to mention how much each provider was actually making after expenses. But, then again, it would be a bit difficult to engender much sympathy knowing that each provider was still making hundreds of thousands of dollars when the average reader is making 30-40K.
Physicians only talk about their expenses, not their income.
And the ignorant don’t focus on expenses, because these must be paid before you can have an income. Could you potentially have a zero income despite working full time? A physician or any other self-employed person theoretically could. At least if you were fired from your job you would not be working for no pay!
This is so ironic to me. I practiced veterinary medicine for 10 years prior to going to medical school. One of the drivers for me to go to medical school was the professional frustration that one of the biggest cash sources in our veterinary practice was the “retail wall” in the waiting room.
We sold doggie vitamins, prescription dog foods, leashes, etc. I naively thought that when I was a “real doctor” instead of a veterinarian, I would be able to focus on the wonderful intellectual feast of patient diagnostics, and made a nice living at it.
I am a general internist, and although I am fortunate to make more than I did as a veterinarian, I’m not sure that I actually make more on an hourly basis (I am afraid to do the math – it would likely prove too depressing!)
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