Of the many obstacles facing primary care, the sheer amount of paper stands out as one of the most burdensome.
There are studies that show that every hour of clinical care generates an additional hour of paperwork. In fact, as Better Health’s Val Jones recently notes, one-third of a primary care doctor’s income is spent on paperwork.
It’s no wonder that the PCP burnout rate is so high, and why so few medical students find primary care appealing.
One solution would be to standardize the forms that private insurers use, which would greatly simplify the administrative burden that offices face.
Or, you can do what Val did, and join a practice that doesn’t take insurance. The practice, DocTalker Family Medicine, simplifies payment for patients, charging them hourly. It only costs $25 per patient per month to offer comprehensive primary care, mostly because of the savings wrung from having almost 90 percent less administrative staff.
We’ll see if a model like this can take off – I’d be curious to see how it does in Medicare and Medicaid-predominant populations – but it did attract the attention of CNN’s Anderson Cooper, who did a story on the practice.
Related posts:
- How do you reduce paperwork for doctors?
- How much time do doctors spend on paperwork?
- Primary care is damn cheap, and can solve our health care woes
- Is loan forgiveness enough to convince students to choose primary care?
- The primary care problem
- Why not a down payment for primary care, and problems with the medical home?
- Primary care-specialty income gap: It’s worse than we think
{ 10 comments }
I think this is a great practice model.
This practice model will be sorely tested under so-called “reform” as it penalizes non-par docs. Gather ye rosebuds while ye may.
This isn’t just primary care. I’m a neurologist, and get this crap too. Worker’s comp forms, FMLA, medication authorization forms, test authorization forms, release to work forms, etc. This effects all fields.
Yes. I think $50 /15 minute should be cost effective and can be made to work. The medical office can eliminate their billing staff, insurance related rejections and save healthcare dollars.
In the past I’ve commented on why medical students don’t want to do primary care. This (excessive paperwork and having to pay armies of people to fight with insurance companies) is another reason. The actual medicine in primary care is difficult enough but the thought of also doing the amount of paperwork required to practice primary care makes me want to vomit. All specialties require excessive amounts of paperwork but primary care is terrible.
Honestly, the idea of a practice that charges patients $25-$100/month (sliding scale based on income) for primary care services (excluding tests) sounds very appealing. I know my parents would sign up for it and I’m sure the physicians would enjoy practicing medicine again (while only completing enough paperwork to keep the lawyers at bay).
Dr. K,
True Story: Insurance company needs an Attending Physician Statement (APS) for a Proposed Insured (PI). The insurance company contracts this info gathering to another service, paying only $50 per APS. The hired service contacts the MD’s office. The MD’s office contracts this to a second company, who charges $90 for APS’. A $40 Mexican Stand-off occurs. Solution? The PI had to go to the MD’s office and demand a copy of his records. Oh, and he have the MD’s office $20 to copy that file. And, could we fax that direct to the Insurance company? Nope. We faxed it to the Insurance Company’s service, who then, I hope, faxed the APS to the Underwriting department.
Sadly, I know about 3,104 more stories regarding paperwork, just like that one.
I just received an advertisement from a doctor the charges $2000 for a year of primary care…everything included. Labs, x-ray, etc. No insurance…no billling except for routine payment….could set these up with automatic billing. I guess you would have some accounting if there was outsourcing Give the money to the doctor instead of the insurance company.
A doctor wouldn’t need very many patients to make a good living. Too bad more doctors don’t just say no to insurance company contracts. Perhaps we would then have a good catastophic options too.
Kevin,
Listen. The key to reducing paperwork is to not create any……Stop creating paper charts, stop creating paper terms of service, stop documenting on paper. That will fix a huge bunch of this. The team we have is workin on that…
Then the paperwork burden is replaced by the computer work burden. No difference.
How is simple documentation via a computer more work?
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