Robert Lowes over at Medical Economics does the math to show how you could earn $6,000 more per year by skipping out on free lunches…
Hearing a drug spiel over a fajita wrap may not disrupt the schedule, but drop-ins and appointments eat up roughly 60 minutes a week, Health Strategies Group reports. If you used that extra time to see four established Medicare patients, using CPT code 99213 for an intermediate visit, you’d collect roughly $60 per visit, $240 per week, and $12,000 over 50 weeks. Subtract 50 percent for overhead, and you’d net an extra $6,000 a year””just a hair under what Brewer cleared after dropping rep visits.
(hat tip: The Medical Quack)
Related posts:
- Medicare’s dismal pay for performance
- How will ICD-10 affect you?
- Nobody visits your fancy, expensive website
- Breaking even on 4 visits per day
- Can this be the year Medicare changes its payment formula?
- "Medicare should pay for DNR orders"
- E-mails and telephone calls to the doctor cut down on patient office visits
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{ 13 comments }
Correct me if I’m wrong but it seems that foregoing $12,000 in revenue in favor of those fajitas will cost you $12,000 a year rather than $6,000.
Most of the 50% overhead that was subtracted represent the fixed costs of running a practice i.e. costs that would have been spent whether those patients had been seen or not (rent, salaries, etc.) The extra (marginal) cost of expenses related to seeing those few extra patients is probably much closer to $0 than to $6,000.
But don’t quote me Captain. I’m a doctor not an accountant!
John
John, you are correct. I would add that the average time spent with detailers is closer to 6 minutes per week, mostly the time it takes me to sign for samples.
Also, don’t forget you have to pay taxes and work for that purported $6000. Since my total tax burden is close to 50%, that would only leave about $3000. For every dollar I manage to collect in my practice, I figure only 20 to 25 cents ever makes it to my pocket.
This is the same mindset our office manager gets into — if you could just see one more consult each day, that would be (then comes the math).
Aside from the fact that the real world math doesn’t work out this way, as pointed out already, one of the things I am trying to do is not have my day so crammed with one patient encounter after another that I begin to dread coming into work every day. There is never as much time as you think there is. A patient encounter seems like it’s X amount of time, but it’s really X plus all the extra time for paperwork, phone calls, reviewing labs, maybe doing research to understand what’s going on…lawyers get paid for all that stuff, doctors don’t.
…and let us not get started on the topic of how much each week out of the office costs…it is on the magnitude of 5% of your income!
One of several reasons that I don’t see them anymore. I find it amusing how a doctor making 100 an hour will debase himself, and lose time from his practice, for a 7$ dollar sandwich.
Now if I actually liked seeing them and thought I got useful information, instead of a manipulative sales job, I might rationalize a reason to do it.
Far better however, to take 5 minutes to close my eyes and clear my head than 5 minutes for a drug rep. The side benefit is that without a sample cabinet, I don’t get pestered by people who make 100,000 a year for free samples all the time.
I never understood why anybody would willingly give themselves over to a vendor/rep for 2+ hours for a fifty dollar steak, either. I have been in a procuring position for 20 years for various departments, and I always tell the vendors that my consulting fee is $300/hour, but that if they pay me for my time I will have to declare a conflict of interest and disqualify myself from recommending their products. That quickly sorts things out. I like the Kaiser approach; no vendors. leave your literature.
I have conflicting views on this because:
(a) both of my parents are physicians,
(b) my wife was a drug rep, and
(c) I worked for a health care company previously.
But the only thing that came to mind was, think how much happier your staff is with those lunches (and dinners)…since the typical staffer replies with a much higher than actual number when the drug rep asks “how many in the office?” Thus, you, your staff, and Corner Bakery/Chili’s/Boston Market/(insert local Mexican food joint) all benefit.
Nothing like a fringe benefit you don’t have to pay for. Well, unless you get stuck talking to the drug rep.
“A patient encounter”
When an MD starts to refer to a patient visit as an “encounter”, perhaps it’s time to change professions.
How about a change to boxing?
When a patient starts to analyze the semaintics of every word, it’s time for a discharge letter.
As a rep, I see that many offices set aside one pre-scheduled day a week for drug lunches – the staff enjoys the free lunch, including staffers making barely more than minimum wage in many offices.
The physician usually comes in for 5 minutes, takes some literature and is on his or her way. The 60 minutes a week suggested in the Medical Economics article is pure hogwash. I have never in my dreams seen a doc spend half that much time in an office drug lunch. A good rep can get his message across in 5 minutes or less. Docs have to eat anyway, so we are not taking away from patient care.
Indeed we are purchasing and delivering the lunch to the office, which actually saves time compared to the doc going out for food, or even down to the hospital cafeteria.
Many physicians in today’s frantic practice environment don’t have the time to learn about new products on the marketplace which may benefit their patients. I provide appropriate peer reviewed information and journal reprints, not just glossy brochures- so (believe it or not) the doc and his patients might actually BENEFIT from the encounter as well. Imagine that.
“One of several reasons that I don’t see them anymore. I find it amusing how a doctor making 100 an hour will debase himself, and lose time from his practice, for a 7$ dollar sandwich.”
A typical non-surgeon physician, at least in my state, makes approximately $75/hr, pre-tax, about $50/hr after taxes. It takes me approx 8 minutes of work to make enough money to buy a sandwich. So it’s worth it to listen to a drug rep to get a free sandwich, as long as it takes less than 8 minutes of my time (and that’s not even counting in the free food for my staff).
Anon 3:24, as a licensed professional engineer, I get my new product news primarily from trade journals specific to my field and from convention exhibits. When I do see a salesman, it is by appointment at my request and only to get technical details, case studies, and local user references that aren’t in the ads. Why would any MD WANT to get their new product news from a biased non-MD salesman who is simply assigned to target them early and often?
To the PE,
With all due respect, engineering is a bit more leisurely than medical practice (I have worked with both engineers and docs extensivey).
Many docs don’t have time to read journals or attend many medical conferences. When they do read journals it is not usually to discover new products. As a salesman, I am presenting information about my product (and so are other sales reps from every company) – however it is always up to the doc to make up his or her mind about the best treatment.
After over ten years in the business, I have never heard of a pharma rep being called by a doc for an appontment. People in my shoes know docs seldom call their own spouses let alone a drug salesman!
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