When specialists provide primary care, and why patients aren’t complaining

That’s why increasing reimbursement for cognition is not a panacea. Specialities do cognitive work as well and can compete directly for those patients. With any type of marketing most patients will choose the specialty. A medicare patient that has a sprained ankle is offered the choice of her familiy doctor vs an orthopedic surgeon at two competing clinics, it’s going to be an easy decision.

I’d interpret this study as further evidence that our society still equates specialists with superior care despite many studies that show for many conditions better outcomes are achieved at lower cost with primary care.

One family physician colleague prefers be called a generalist and refers to specialists as partialists in his attempt to take some shine off of this apple.

do specialist actually get paid more or do they do more procedures that get reimbursed better?

I have spoken to one of my friends who’s a family physician and we get paid exactly the same for the same code?

I just got a bill from my PCP. Of course I didn’t see my doctor, I saw one of the PAs because my doc was too busy-$290. That’s more than I spent on my first visit to a specialist I work with for a complicated medical condition. I regret not having got to him instead. At least I would have seen a doctor.

I get paid the same as any generalist in my community for the same office CPT codes. And procedures come with mandatory post-procedural followup, usually 90 days, where none of the visits are paid.

What the complaining generalists envy is pay for procedures, not the hours of postoperative care involved, or the preoperative evaluation or the additional years required to master those procedures, or the added costs of materials and supplies to be able to do those procedures or the extra malpractice insurance costs involved.

And how many family doctors do OB or colposcopy or colonoscopy? All that is within the range of available practice options, if you want to bill for procedures. What I am hearing is whining about not getting procedural pay for non-procedural work. Here’s news, specialists in so-called “procedural” specialties don’t get that either. In fact, many office visits associated with those supposedly lucrative procedures are bundled with the procedural fee and get paid nothing.