Comments on: "The days of the wealthy physician are over" http://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html Tue, 14 Feb 2012 20:59:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-75232 Anonymous Sat, 19 May 2007 15:36:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-75232 I am a surgical subspecialist that takes call for our practice and the other practice in town as well as the local ED. We make less money than the national average in our specialty and enjoy the high cost of living in New England. This ED call thing... it's not all just about money. We seldom use the hospital and it is a financial loser for us. We need our privileges to stay on our insurance plans and continue to operate. The staff bylaws are very tight about call and noone is exempt unless released by their department. Other than the control issues of policy with the hospital...we feel an obligation to our fellow docs in the ED not the hospital corporation. Those are the realities and "fox hole" feel good reasons we take call. The not so savory area is that our "not for profit" hospital continues to expand, hire hospitalists for the primary care docs, has purchased approx. 75% of the medical staff including urology and surgery and is the largest employer in our city. If they roll out another capital campain/physician extorsion plan I will surely die. There are a growing number of us that would like to be compensated for our work but fear we are not coming into this from a position of power when we approach the hospital. The administration pays themselves handsomely and enjoy "Bergermeister" authority. It would be easier to give of our time if they were in dire straits or we were a charity hospital with a mission of charity. Let's call a spade a spade...they are a business as are we. We are trapped by our moral and ethical obligations and they are not. If change is not coming, I plan on retiring as soon as I can afford to. I am a surgical subspecialist that takes call for our practice and the other practice in town as well as the local ED. We make less money than the national average in our specialty and enjoy the high cost of living in New England. This ED call thing… it’s not all just about money. We seldom use the hospital and it is a financial loser for us. We need our privileges to stay on our insurance plans and continue to operate. The staff bylaws are very tight about call and noone is exempt unless released by their department. Other than the control issues of policy with the hospital…we feel an obligation to our fellow docs in the ED not the hospital corporation. Those are the realities and “fox hole” feel good reasons we take call. The not so savory area is that our “not for profit” hospital continues to expand, hire hospitalists for the primary care docs, has purchased approx. 75% of the medical staff including urology and surgery and is the largest employer in our city. If they roll out another capital campain/physician extorsion plan I will surely die. There are a growing number of us that would like to be compensated for our work but fear we are not coming into this from a position of power when we approach the hospital. The administration pays themselves handsomely and enjoy “Bergermeister” authority. It would be easier to give of our time if they were in dire straits or we were a charity hospital with a mission of charity. Let’s call a spade a spade…they are a business as are we. We are trapped by our moral and ethical obligations and they are not. If change is not coming, I plan on retiring as soon as I can afford to.

]]> By: Internal Medicine Dochttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71989 Internal Medicine Doc Mon, 19 Feb 2007 20:22:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71989 The issue of covering indigent call has had a great impact on primary care in Northern Kentucky. The largest provider of indigent care in the area will only provide "9 to 5" care for patients. Patient's are now "abandoned" to the ERs at night and on weekends where they enevitably are admitted. These admissions are forced other primary care practices for the "priviledge" of caring for your own patients in the hospital. <br/>In 2006 the number of such cases rose from 10% to 40% of our admissions.<br/>Without the hospital "stepping up to the plate" and reimbursing for this burden we will no longer be able to remain finacially viable and cannot continue to provide inpatient care. The issue of covering indigent call has had a great impact on primary care in Northern Kentucky. The largest provider of indigent care in the area will only provide “9 to 5″ care for patients. Patient’s are now “abandoned” to the ERs at night and on weekends where they enevitably are admitted. These admissions are forced other primary care practices for the “priviledge” of caring for your own patients in the hospital.
In 2006 the number of such cases rose from 10% to 40% of our admissions.
Without the hospital “stepping up to the plate” and reimbursing for this burden we will no longer be able to remain finacially viable and cannot continue to provide inpatient care.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71758 Anonymous Thu, 15 Feb 2007 01:03:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71758 After 7 years, I just closed my practice and started a mobile imaging company. Free market, here I come!!! After 7 years, I just closed my practice and started a mobile imaging company. Free market, here I come!!!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71669 Anonymous Tue, 13 Feb 2007 15:41:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71669 "How will physicians ever be able to survive on the low six figures? Ohh the humanity!"<br/><br/>They won't. They'll leave medicine and go into business. “How will physicians ever be able to survive on the low six figures? Ohh the humanity!”

They won’t. They’ll leave medicine and go into business.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71667 Anonymous Tue, 13 Feb 2007 15:16:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71667 Every business skill available? Judging by the way some of you whine it appears your business skills are limited. You'd wither and die in the real free market. Every business skill available? Judging by the way some of you whine it appears your business skills are limited. You’d wither and die in the real free market.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71663 Anonymous Tue, 13 Feb 2007 04:51:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71663 For the stereotypical idiot anon 8:54:<br/><br/>low 6 figures. 6 figure debt. Plus every business skill availble to scrounge and get 6 figures. <br/><br/>It's the hardest 6 figures to scrap together. For the stereotypical idiot anon 8:54:

low 6 figures. 6 figure debt. Plus every business skill availble to scrounge and get 6 figures.

It’s the hardest 6 figures to scrap together.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71659 Anonymous Tue, 13 Feb 2007 02:40:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71659 "How will physicians ever be able to survive on the low six figures? Ohh the humanity!"<br/><br/>Well said by another envious, personally insecure whiner that somehow feels better if he/she thinks hard working successful people are getting cut down to their level.<br/><br/>Must be graduate of public education specializing in liberal self defetism. “How will physicians ever be able to survive on the low six figures? Ohh the humanity!”

Well said by another envious, personally insecure whiner that somehow feels better if he/she thinks hard working successful people are getting cut down to their level.

Must be graduate of public education specializing in liberal self defetism.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71652 Anonymous Tue, 13 Feb 2007 01:54:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71652 How will physicians ever be able to survive on the low six figures? Ohh the humanity! How will physicians ever be able to survive on the low six figures? Ohh the humanity!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71651 Anonymous Tue, 13 Feb 2007 01:50:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71651 The government, payors, and even hospitals have conspired to reduce physicians to the level of labor that can be controlled by those more powerful entities for their benefit now. Now they complain because they find that labor expects to be paid to show up? The government, payors, and even hospitals have conspired to reduce physicians to the level of labor that can be controlled by those more powerful entities for their benefit now. Now they complain because they find that labor expects to be paid to show up?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/02/days-of-wealthy-physician-are-over.html#comment-71647 Anonymous Tue, 13 Feb 2007 01:00:00 +0000 http://clients.emmense.com/kevinmd/2007/02/the-days-of-the-wealthy-physician-are-over.html#comment-71647 Taking call at hospital emergency department is charity work, paid or not. It is true that nobody in their right mind wants to do after hours care, much less risk their neck going to the ER in the middle of the night. And ER patients interrupting 60 or more patients a day in the office certainly cannot be accomodated. The solution is not paying private doctors to cover call they realistically cannot cover, but large hospitals like you did your at with staff and residents/fellows filling in the gaps. Oh, and getting the nonemergencies to be seen in the office. Taking call at hospital emergency department is charity work, paid or not. It is true that nobody in their right mind wants to do after hours care, much less risk their neck going to the ER in the middle of the night. And ER patients interrupting 60 or more patients a day in the office certainly cannot be accomodated. The solution is not paying private doctors to cover call they realistically cannot cover, but large hospitals like you did your at with staff and residents/fellows filling in the gaps. Oh, and getting the nonemergencies to be seen in the office.

]]>