Dr. William Schreiber, whom we will call Dr. Bill, a primary care physician, said cuts in Medicare payments to doctors will force them to consider boycotting Medicare patients.
http://money.cnn.com/2010/03/04/news/economy/medicare_doctor_costs/index.htm
www.LinkToMeet.com reporters did an analysis and find some holes in his story. Let's face it. Doctors automatically assume that because they spent half their life in school, that they must earn $500K per year minimum, drive an $90K Mercedes and live in a $1 Million home. Now, if Dr. Bill takes some of his income and invests it properly, I have no problem with him having those fin things in life. Most wealth is made from investments, not income from working; earned income.
Please refer to the article above on CNN, to undestand where we get the numbers.
$88 medicare pays, charges $120 per 1/2 hr for complex problems
$58 med pays, $92 charges -sick visit 15 min
BS charges
$44 med pays, $70 charges - blood pressure / cholestoral check (draws blood) - nurse does no doc time.
- bogus because lab charges separate. Include 1 for every 2 visits or 50% of 3 /hr
(44*3)/2 = $66 per hr X 8 = $528 per day, X 230 days = $121,440.
70% medicare, balance private insurance, which pays 15% above medicare on avg.
1 $88 per 1/2 hr, 2 $58 1/4hr = 88+58+58=$204 per hr + (70, which is 30%, at 15%=$10) = $214 per hr total
X 8 hrs = (214*8) = $1712 per day
X 230 work days per year = $393,760.
Expenses
1 doctor at $50 per hr, 1 nurse at $30 per hr, 1 office mgr at $20 per hr = $100 per hr labor costs = $200K per yr labor
$ 12K per yr, $1K malpractice and reg insurance per month or $12K per year.
$ 18K per yr, $1.5K per month health insurance or $18K per yr
$130K per yr, $5K rent per month office (max), plus $2K util, plus $300 phone, internet, cable TV, $2k per month supplies, $10K acct and legal
$ 30K per yr, equip rental
$ 10K per yr, seminars, dues, etc.
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$200K per yr office exp
$200K per yr Labor
$ 70K per yr Payroll taxes
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$470 grand total exp.
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230 work days per year
Doc is losing money. His practice loses (394 max - 470 exp) $76K per yr. Deduct vfrom his $100K salary above.
Ok, at best Doc earns $2K per month, or $12.50 per hr.
Oh. That's before medicare's planned 21% reduction in payments.
Solution is, squeeze in double the appts and make nurse and office mgr work late to do billing.
Screw patient care!
OK. Send them to a specialist and get a kickback!
Oh, I forgot to add the bogus Blood pressure check, which the nurse does at $121,440 per yr.
Take Docs net pay of $24K per yr + 121K per yr = $145K per yr, plus double squeezed in extra appts of $394K per yr.,
and Doc now makes (145+394) = $539K per yr. Now that is not bad!
If Doc didn't pad expenses and $60K per month legit, add $220K to exp, remove from his net.
Doc makes (539-220) $319K per year, with squeeze ins.
Dr. Bill is full of crap. He needs to work more hours, or work faster.
We will all need to prepare our list of issues, prior to a doctor's visit, because we each get 7 minutes with the Doc.
Doc still has plenty of income to write off his student loans and big house.
We did not ask him to buy a $1 Million residence and a $90K Mercedes.
You become a Doctor because you want to help people, not make the big bucks, or am I wrong?
Yes. Dr. Bill put in long hours and money in finishing Med school, plus residency. Yes. He deserves to make a decent living. But, I think $319K per year is enough for a 1 doctor practice. If he wants to make more, hire Physician Assistants at $100K, based on them seeing one patient every 10 minutes. Each additional PA adds $100K to Dr. Bill's bottom line. Yews. He needs 1 more nurse, plus 1 more office staffer for each PA he adds. His 5K square foot office can handle 1 or 2 more PAs, before a bigger office is required. That is figured in to the equation of each PA adding $100K to his bottom line.
The 21% paycut is bogus, because that is based on the higher rates Medicare will base their payments on. Medicare raises their rates annually, but because costs spiralled out of control, Medicare had to make an adjustment.
So, Dr. Bill. Add 8 PAs to your office; expand into bigger quarters, and add $800K to your $319K. Now your can make over $1 Million per year. Is not enough for you Doc?