A worrying trend ... Doctor's are going broke.

[vi edit]

Specialists (in general) already make enough damn money. Drive around a staff parking lot in a hospital and tell me how many brand new BMWs/Mercedes-Benz/Porsche/Inifinties you don't see.

Fixed that for you.

 

[destrekor]

Not in my area. This Christmas season walking around in our mall I was surprised to see very few fat people, like almost none. I work at a high school, and out of 2000 kids we only have a handful that are fat. Even women in their 40's and 50's look good now, I remember growing up thinking older people were just fat by default. Now many of these older women look really hot lol.

When we spoke with our insurance agent this year he said it would be the first year that our rates would go down, because a lot of people live healthier lifestyles now. Gyms are always packed, lots of new gyms opening up, and I know very few people that still smoke...especially since it's $10/pack now and you are very limited to where you can smoke.

Your area must be the exception.

A lot of insurance rates went up this year.
And I still see the same number of smokers and fatties.

 

[OutHouse]

The problem will correct itself, once the glut of doctors disappear then the remaining ones will make big money.

there is an overage of doctors??

 

[AyashiKaibutsu]

Malpractice is but a small part of the problem. People who think we just need to fix that and we'll be good are delusional.

 

[Slew Foot]

It mostly depends on your payer mix. In rural areas you're going to have mostly uninsured/medi-cal /Medicare patients whose payment doesn't cover the cost of treatment. In wealthier areas price ate insurance or cash paying patients can allow for nicer lifestyles. When I go to the hospital in Hollister, a rural farming town, the doctors lot has 8 year old used accords. The plastic surgery center enter in San Francisco was full of Mercedes s500.

 

[IAteYourMother]

Doctors (in general) already make enough damn money. Drive around a staff parking lot in a hospital and tell me how many brand new BMWs/Mercedes-Benz/Porsche/Inifinties you don't see.

Are BMW/Benz really even much of a status symbol? I feel like anyone with a decent paying job can afford one now.

 

[PricklyPete]

This may be true based on data collected, but my anecdotal experience (both in large cities and rural areas like where my wife's parents live) tells a different story. Many relatives, friends, and past neighbors are doctors and all of them are doing VERY well from a incomer perspective. Not all of them are very good at keeping their income though as many feel the need to live the lifestyle assumed of a doctor/physician.

 

[PricklyPete]

Are BMW/Benz really even much of a status symbol? I feel like anyone with a decent paying job can afford one now.

This perspective is what I have a feeling is really going on. People think that driving a 60k car around is just normal...and then say they are broke. 500K houses, 60K cars are NOT NORMAL. I knew a girl who made very little and bought a 30K SUV because she thought she needed it (she didn't). Then she complained all the time she didn't have money and was "broke". She made herself broke...not her job and not society.

 

[dud]

I read every post in this thread, and this trend is still what worries me the most..

You got me there. I was working on a contract and had the possessive form on the brain. The correct title should have read "A Worrying Trend ... Doctors are Going Broke".

I hope that makes you happy ...

 

[Imp]

This perspective is what I have a feeling is really going on. People think that driving a 60k car around is just normal...and then say they are broke. 500K houses, 60K cars are NOT NORMAL. I knew a girl who made very little and bought a 30K SUV because she thought she needed it (she didn't). Then she complained all the time she didn't have money and was "broke". She made herself broke...not her job and not society.

I'm not that big a car person, but I did some exploring last week on what I could afford. Ya, turns out I can afford a Porsche 911 (base model). My bank accounts would be emptied, and I'd be living off bread and water, but hey, I can show off my $100k paperweight to all you losers!

 

[AyashiKaibutsu]

Are BMW/Benz really even much of a status symbol? I feel like anyone with a decent paying job can afford one now.

Depends on how much you're willing live for your car/what you consider a decent paying job. Whatever the case, I can assure you the vast majority of americans aren't in decent paying jobs.

 

[Zedtom]

*edit* In healthcare when you bring insurers in, you have an encyclopedia of diagnosis codes and dictated procedure notes that have to be done in a specific way and phrased in particular manner and match a checklist of other factors to be submitted off to a payer that makes sure you did everything in the nitpick way that they wanted it to be in and that you made sure you had all of your i's dotted and t's crossed as to why you did what you did and then they'll try to negotiate back for $XX dollars when it might have really cost you $YYY dollars to do that. And depending on who exactly is paying that bill that reimbursement rate is one price with payer X and a different one with payer Y. And a lab draw for payer X has to be done and reimbursed one way while payer Y requires it to be done a different way. And then when the bill goes to the patient it's got one charge on it for the "billed" fee and then a second one for the negotiated fee. And then sometimes another one for the amount that the patient actually owes.

*edit* The medical industry and insurance companies (private operated or government entities) have royally screwed things up for everyone.

There are doctors leaving their practices because the billing procedures are too arcane and frustrating to deal with.

 

[cKGunslinger]

You got me there. I was working on a contract and had the possessive form on the brain. The correct title should have read "A Worrying Trend ... Doctors are Going Broke".

I hope that makes you happy ...

It does, but I'll ask my doctor for some more Valium, just in case. :thumbsup:

 

[ichy]

Part of the problem is that the independent, single-physician practice is a ridiculously inefficient model. For physicians who are doing badly payer mix is often the root cause of the problem. I have an aunt who's a doctor in a shitty little town in Oregon and apparently their finances are really hurting because of the huge number of Medicare and Medicaid patients. Physicians needs to be better businessmen, but we can't expect them to live off of patients whose insurers pay squat.

 

[GuitarDaddy]

Far too often doctors are extremely poor businessmen, and unless they have a talented and competent business manager that runs the finances for their practice they don't have a clue how much they actually make and spend way beyond their means. I think this is why more and more you see doctors join groups that consolidate and centralize the business functions of many doctors practices and simplify their finances.

And our current system is destroying rural practices, and is not inticing new young doctors to open practices in these areas. In our current "for profit" healthcare model it's just not profitable to provide healhcare in rural or low income inner city areas.

 

[alent1234]

When an electrician hands you a bill it's simple to read. When a plumber comes out and fixes your toilet and hands you a bill it's pretty straight forward for what you are being charged for. Same thing really for when you do something even as complex as a house. There's a charge for materials and a charge for labor. End of story.

But in healthcare when you bring insurers in, you have an encyclopedia of diagnosis codes and dictated procedure notes that have to be done in a specific way and phrased in particular manner and match a checklist of other factors to be submitted off to a payer that makes sure you did everything in the nitpick way that they wanted it to be in and that you made sure you had all of your i's dotted and t's crossed as to why you did what you did and then they'll try to negotiate back for $XX dollars when it might have really cost you $YYY dollars to do that. And depending on who exactly is paying that bill that reimbursement rate is one price with payer X and a different one with payer Y. And a lab draw for payer X has to be done and reimbursed one way while payer Y requires it to be done a different way. And then when the bill goes to the patient it's got one charge on it for the "billed" fee and then a second one for the negotiated fee. And then sometimes another one for the amount that the patient actually owes.

So really...the construction trade is nothing like the medical industry and insurance companies (private operated or government entities) have royally screwed things up for everyone.

in 2012 we have things called computers that do these things. a lot of the doctors i know still use paper and do everything manually because they think every little expense is money out of their pockets

 

[ichy]

I suspect you're going to see doctors in more large practices run by professional managers or as hospital employees. That and more physicians who refuse to take Medicare patients.

 

[rh71]

A problem in bumblefvck Idaho maybe. Even in my smallish suburban town there are quite a few family doctor practices in many specialties.

 

[Anubis]

the biggest issue is that the reimbursement rate has gone down like 80% in 20 years while the cost of school/living/doing busniess has gone up 80%

unless you are the worlds best or a specialist you really dont make THAT much money for what you have to put into being a doctor

the massive bills you see from hospitals are not from the Doc its the hospital itself billing you 50k for 2 days, the dock if he sees you might bill you 2-5k depending on what you were in for

 

[rudder]

Doctors (in general) already make enough damn money. Drive around a staff parking lot in a hospital and tell me how many brand new BMWs/Mercedes-Benz/Porsche/Inifinties you don't see.

$150,000 medical school debt on average, 4 years pre-med, 4 years of med school, 3 to 7 years of internship.... how many people would do that to be able to drive around in a 1998 honda civic?

And if a welder welds the wrong pipe... do you think they are subject to million dollar lawsuits? If a welder sees a broken pipe out in public is he obligated to fix it? Aside from the time and expense of becoming a doctor, there is quite a bit of responsibility that comes with the title.

 

[JeffreyLebowski]

Although I too believe in the "invisible hand of the market", this market may be rigged. Insurance companies including medicare and medicaid control the supply and the demand of the equation. They tell you how much they will pay and you have to accept it. People no longer choose the cheaper price as they would if they were spending their own money. The go to whatever doctor will take them.

You kind of got it right. Medicare and Medicaid are the problem. Doctors got used to ripping off the tax payers and built their practices around it. Now that Medicaid and Medicare are tightening the purse strings, it's going to hurt the dishonest doctors.

 

[Vic Vega]

Perhaps these doctors should reduce their salary and put more money back into the practice? Hmmm....

 

[JeffreyLebowski]

Doctors around here own lots of guns.




I am talking about southeast Texas here, in the past 10 - 15 years I have seen a reversal between labor and technology jobs.

In the late 1990s, a microsoft certified systems engineer could make almost twice what a welder could make.

Now, good luck finding a tech job because the market is flooded. But if you can weld, do manual labor, work metal,,, you should have no problem finding a job. My son-in-law got a construction job a few weeks ago making almost $20 an hour + overtime.

There has been a disturbing trend over the past 2 decades in the rural US. The older doctors are retiring, and no new doctors moving here to replace them.

It's called modernization. Young people don't want to live in the rural areas. Becoming a doctor isn't cheap. If you want to pay off your debt, you work in a big city.

 

[Fritzo]

The problem will correct itself, once the glut of doctors disappear then the remaining ones will make big money.

Ooohhhhh...so there's TOO many doctors! That explains why it only takes 3 months for me to make an appointment.

 

[BlahBlahYouToo]

Although I too believe in the "invisible hand of the market", this market may be rigged. Insurance companies including medicare and medicaid control the supply and the demand of the equation. They tell you how much they will pay and you have to accept it. People no longer choose the cheaper price as they would if they were spending their own money. The go to whatever doctor will take them.

There is no invisible hand because thus is not a fre market.