How more and more physicians are supplementing their income. That’s what declining reimbursements will do to you:
Removing hair from unmentionable parts of ladies in Westchester County is how my friend Jerry spends a good part of his week. Not that there’s anything wrong with that, except Jerry (not his real name) is a cardiologist, trained at one of the finest medical programs in the country. Trained to save lives. His expertise is the complex and delicate management of congestive heart failure, but he gets paid a lot more to do a laser Brazilian.
(via Dr. RW)
Update:
Orac chimes in.
Related posts:
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- The medical blogosphere on Elizabeth Edwards’ cancer
- Patient care versus maximizing income
- Primary care-specialty income gap: It’s worse than we think
- My take: Night float, free medical school, triage and disease management
- Alternative medicine invades medical schools
- Alternative medicine invading medical schools
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{ 11 comments }
Color me unsurprised. My PCP does pulsed light treatments for veins and hair removal on Saturdays between 9-2. This is his biggest revenue-generator.
Whatever works.
I don’t understand the ethics of this at all. Physician’s trained in the art of medicine, practicing non-medical cosmetic care. But there is no uproar about this.
Instead, while I promise to provide the best medical care I’m capable of for a fee, concierge medicine is viewed by many in mass media and academic cohorts as some sort of “scheme” or way to prey on patients.
Is this just about the money?
Yep. Here’s a post on why every doc needs a medial spa: http://www.medicalspamd.com/the-blog/2007/2/6/do-all-doctors-need-a-medical-spa.html
“RB MD is a cardio thoracic surgeon who’s been practicing for 20 years in a different state. His credential list is as long as my arm. He told me his average take home check for heart surgery and 60 days of post op care… is $1800. RB MD would like to have his life back. He’d like to spend some time with his wife. He’d like to have an income that wasn’t dependant on others. In short, he thinks he’d like to have a cosmetic practice.”
I had heard about underpaid docs, but never thought it would come to this!
Evetnually we will et to the point where the only people who go into medicine (and stay in medicine) are people with psychopathology that is improved when they help others.
There is simply no other reason to stay in medicine in 2007, and there is no reason at all to enter this profession. I have yet to meet one physician in any field who wants any of their children to go to med school.
I would sure like to know what kind of lifestyle this cardiologist is living that he must do this. If one of the BEST cardiologist who trained at one the best schools cannot make a living without resorting to this I think he needs to hire a CFO.
I think what some of your NORMAL lifestyles are may be so different from the average working person that you consider it all normal. Does he own a yacht? How many homes and families is he supporting? Does he have a gambling problem? Is he on drugs?
Because I just don’t buy that a cardiologist can’t afford to live…Sorry, maybe some people will buy that but not me!
“Because I just don’t buy that a cardiologist can’t afford to live…Sorry, maybe some people will buy that but not me!”
Who cares about your opinion!
“I think what some of your NORMAL lifestyles are may be so different from the average working person that you consider it all normal. Does he own a yacht? How many homes and families is he supporting? Does he have a gambling problem? Is he on drugs?”
You are correct. It is easy to forget the average person is not spending 60 or 70 hours a week at their job, and that they are they get time-and-a-half after the first 40 hours worked. You assume this is normal if you are a cardiologist.
No, he doesn’t own a yacht. These are for people with lots of money and free time to entertain.
There is a good chance he is supporting an ex-wife and paying child support. High rate of divorce among physicians who are never home.
Yes he has a gambling problem. Everytime he cares for a patient he gambles on the outcome and whether he will lose a suit.
He is not on drugs, but he should be. He does not have time to see the doctor himself and is in denial about his own elevated cholesterol, blood pressure, and glucose. Much less not on the anti-anxiety or anti-depressant medications any “normal” “average” person would need given the circumstances. He will, in fact, most likely drop dead of a heart attack.
Hope this clarifies matters.
You are correct. It is easy to forget the average person is not spending 60 or 70 hours a week at their job, and that they are they get time-and-a-half after the first 40 hours worked. You assume this is normal if you are a cardiologist.
Don’t know much about cardiologists – although my friend’s daughter who finished her residency and fellowship a couple of years ago is doing just fine financially. But you are wrong if you think that most people get overtime pay – that is unless you want to trade places with a factory worker.
In fact, most professionals – engineers, scientists, computer programmers – are “exempt” from overtime pay. And many of us work way more than 40 hours. The deadlines have to be met no matter how unrealistic they are.
I am a software engineer, and I had projects when the schedules were so crazy that I worked on weekends, Thanksgiving, Independence day a few years in a row. Sometimes I work from home during vacation. And no, I don’t get overtime pay or comp time.
We don’t get raises every year either, and our salaries are not adjusted for inflation. You may do a great job, but if you company failed to meet market expetations – here goes your raise. And if you are not happy – well, there are plenty of people in India and China who can do the same job for much less.
So no, the majority doesn’t get overtime pay. Unless you want to change places with factory workers.
There is nothing unethical about a physician entering another line of business. It isn’t the high calling of saving lives, but if it pays better and that is what is important to him now, there is nothing wrong with it. It beats insurance fraud or pushing unneed surgeries on sick people–that is unethical.
I don’t think it is a matter of whether he is trying to live too well or not, that is his decision. I live on a fraction of my income as a psychiatrist, but that is how my wife and I want to live–almost as college students.
The real issue here is that this shows the real value of physician’s skills in the free market is much higher than the government/insurance monopsony marketplace recognizes
.
As observed, I believe by Hayek, government price setting and regulation always lead to shortages and declining quality and increasing dishonesty in any market. If medicine continues down the road of stifling regulation and an inability to set market prices, the future is one of shortages of the supply of services as the dynamic personalities in our profession that have driven service development in our communities seek freer and greener patures in which to create and innovate.
Those who remain will be too often be tempted into dishonest practices in a guerilla war against insurers in a downward price spiral. Then the remaining doctors will be in a situation with the insurers in which they tell us: “You pretend to submit accurately claims, and we will pretend to pay you.”
My advice to all physicians is to calculate your actual overhead on a per hour basis. For example,if the overhead is 100$ per hour, including your salary, then you would be foolish to schedule any 30 minute appointment not paying at least 50$.
STOP BEING A DONKEY FOR THE COLLECTIVE. If you are doing work that you do not get paid for, or worse that actually increases your overhead without any additional reimbursement, then, unless you are financially independent, you are committing financial self destruction. When people complain just say, “It is not my problem. I’m not your collective donkey.”
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