Dr. Rob nails it. He has taken the fee-for-service system given to him and makes the most of it.
We in primary care have an access issue. People wait months for an appointment. The demand is clearly there.
Doctors who don’t find innovative ways of increasing their access are, i) causing patients to be further unsatisfied with their care, and ii) leaving proverbial chips on the table.
Medicine is indeed a business. Primary care physicians who don’t treat it as such won’t survive in the current environment.
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There are geographic differences on this point. In my lower-middle-class area, most patients have HMO insurance (if they have any insurance at all).
For these HMO patients, it’s a $10 co-pay no matter when I see them. Ten dollars does not even cover the overhead of their presence in the office.
In such a practice, the most lucrative patients are the patients who sign-up with a doctor, but never go.
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