Doctors Are Not the Bad Guys

In my business strategy consulting work, one of the services I provide is to perform operational assessments.  I do a large portion of this work in the healthcare arena, and recently I have been trying to assess the overall direction in which the healthcare world is moving so I can better evaluate the circumstances of my individual healthcare clients.  I was thinking about this the other day when my husband asked me a thought provoking question – “When did the doctor become the bad guy?” He was referring to the fact that reimbursement to doctors continues to be cut at the same time that more expectations are being mandated.  I have met many doctors in my 26-year career as an RHIA who truly do care about their patients.  Most doctors want to spend more face-to-face time with their patients.  And most doctors only want to provide excellent treatment and quality services to their patients.  Yes, just like any industry, there are few bad apples–those are the few that provide substandard treatment and commit Medicare fraud.  Contrary to the headlines, these are the exception, not the rule.  Another thing that is grossly misunderstood in this country is the average salaries for physicians.  Sure, there are some specialties that make a lot of money, but the average primary care physician is not in that category.  You may be asking yourself, “Why should I care how much a doctor makes?”  Let me help you understand.

1.  The average physician is 0,000 in debt when they graduate from medical school.

2.  A new physician will spend, at minimum, three years in residency.  Residents make between -50K per year.  Due to the new laws concerning student loans, a resident must begin repaying their loans as soon as they graduate from medical school.  Average payment is 00 per month, which means that they have -26K annually to live on during the three (or more) years of residency.

3. New laws limit residents to working 80 hours per week.  (80 hours per week!!)

4.  If the physician chooses to remain a primary physician with no additional specialization, he or she can start a private practice after completing residency.   To buy into an existing practice will cost an average of 0,000, which is usually borrowed and added on to their school loan debts.

5.  Their average gross annual revenue after five years of practice is approximately 8,000.  Sounds great, right?   Maybe not, when you take into account that this is before general operating expenses.  Those expenses for a new practicing physician add up to about 3,000 a year.  Notice a problem with the numbers here?  (The expenses are greater than the revenue.)  And these numbers do not include any salary for the physician.

6.  It takes a primary care physician 12 years before he sees any chance of breaking even.  (Read Dr. Kevin Pezzi’s article http://www.er-doctor.com/doctor_income.html)

We all need to care about the medical community. We are currently experiencing a shortage of primary care physicians, and yet we are getting ready to experience significantly greater access by patients because of government mandates.  The current patient population sees a physician an average of 3 times per year.  We know that a primary physician usually sees an average of 24 patients per day.  It would be realistic to say that if the physician sees more than 24 patients, the time for patient interaction and the level of quality care will have to be adjusted (downward).  Not only will the physician have less face-to-face time with each patient, but also they have to enter the orders into mandated computer systems, ensure treatment is covered by the insurance company, evaluate test results, and document all the expected information for the insurance plan and medical record in precisely phrased and coded form.  They are expected to stay current on the most recent research for your treatment and required to take certification examinations every three years to prove their continuing competency as a medical provider.  And like everyone else, they want to have a personal life too, with time for their family and friends.

In this day and time, a primary care physician (family practice, pediatrician, and internal medicine) cannot go into practice expecting to make money, but the general public does not understand the expectations and requirements of the medical community.  The system appears to be designed to discourage otherwise qualified and capable people from entering the medical field.  The next time you hear someone criticizing the medical community, please ask them to step up and serve.  Maybe they can help make up the difference in the shortage and be willing to donate the long hours of service for minimal compensation.

But where does that leave me in helping my healthcare clients optimize the performance of their practices—maximizing returns and minimizing expenses?  That will be the subject of many future articles.

Reference sources: www.mgma.com and www.aafp.org

Penny Crow is the Founder and CEO of Operational Strategies, a management consulting firm with consultants who have become subject matter experts in their various areas of specialization. She can be reached at (512) 394-8696 or penny@operational-strategies.com

About Jason Myers

Jason Myers is the editor-in-chief of the Texas Entrepreneur Network and can be reached at jason@txenetworks.com