Doctors Charging "Membership" Fees

[AmberHeartsDisney]

Id say SEE YA DOCTOR!!!

for that he better be coming to my house once a month for that.

 

[torinsmom]

Not picking on teachers, but this sounds like the real world that the rest of us work in.....

With State and Municipal budgets in crisis, teachers are now only seeing what it's like to work in a competitive world.

If you look back at my post, I wasn't really complaining. Just showing that its not just doctors who may not be getting what they thought they signed up for. It's just a fact of life. Doctors are no different, IMHO.

 

[ssawka]

Well, a friend of mine recently opened a veterinary practice. He's renting about 2400 sq. ft. of office space. I estimate he's paying somewhere around $26,000 a month in rent--and we're not talking a high maintenance area--so that'd be $312,000 just in office RENT. And I think he got about half of the space at a slight discount.

See, that's the thing; I don't think people realize how all this stuff ads up or how much it costs. Just add in salaries, insurance for employees, pension costs, sick time, paid holidays, other PTO, permits, licenses, supplies, equipment (there's a biggie), I think $600,000 would be conservative.

And his hours? Two days a week he's scheduled 11 hours. Two days a week he's scheduled 8 1/2 hours. One days he's scheduled 4, as well as every other Saturday. I stopped on his half day--he was still seeing clients at 3 PM. All his "office work"; callbacks, calls confering with other veterinary specialists, management time...all extra. Just like with our physicians.

Just a question, not trying to be confrontational, but isn't it a doctor's choice to open up a private practice? If the cost is so high, wouldn't the doctor be better off working for a salary at a hospital or health clininc? If the doctors are losing so much money and having a hard time making any profit, why would any doctor open a private practice?

 

[clarabelle]

Doctors that work for a hospital may make less money than doctors in private practice. (not always)
For example a physician employed at a VA or teaching hospital would probably make less money than in private practice -but there are lots of variables.
Part of the country, population, percentage medicare or medicaid, size of practice- solo or group?
If you were a dept chairman or similar at a teaching institution you would probably do better than private practice.

Family doctors in my neck of the woods can certainly do well -but they need some help. The business part may be overwhelming if they don't have someone to advise them.
Also health care is ever changing -it is a constant struggle to keep up with insurance coding , rules and regulations ect...
So yes it is their choice -but they may have not known what they were getting into.
Spending your days filling out disability paperwork or insurance forms may not be what you had in mind at med school. You know those commercials you see on TV for Diabetes supplies or scooters? Those things take pages of forms to be filled out by the physician. Prescription pre-approvals? more forms , FMLA -loads of forms
I think that is the kind of thing that a concierge physician is trying to escape.

OP -I think you should read the letter carefully -maybe call and ask some questions.
I wouldn't hesitate to switch to someone else if you don't like what you hear.

I am surprised however that a business decision is causing so much controversy.

 

[dvcgirl]

If you look back at my post, I wasn't really complaining. Just showing that its not just doctors who may not be getting what they thought they signed up for. It's just a fact of life. Doctors are no different, IMHO.

I don't know what you mean...."that Doctors are no different"....I think that physicians completely get that they are in a competitive world and that's why some of the best docs are going to this model where they are able to make more money and limit their practice....which also enables them to provide better care. And that's why many are dropping medicare patients as they see that they can no longer earn a decent living with medicare reimbursements falling.

 

[melancholywings]

I think part of the problem is the cost of education as well. I don't think the cost of health care can come down with out the cost of educating people to do health care comes down.

 

[fkj2]

Just a question, not trying to be confrontational, but isn't it a doctor's choice to open up a private practice? If the cost is so high, wouldn't the doctor be better off working for a salary at a hospital or health clininc? If the doctors are losing so much money and having a hard time making any profit, why would any doctor open a private practice?

It is a choice and apparently, with as many docs turning to hospital based employment, one they're regretting. I just don't think hospital employed docs are quite as accessible as those running their own practices. One of our local hospitals that I am aware of manages the medical aspect of the patients once they are admitted. The private PCP doesn't resume primary responsibility until discharge.

And you have to remember that physician's who opened their practices in the mid-80s have seen extensive changes in the delivery of medicine. That's why some of them are leaving their practices now. More and more of those finishing their residencies are accepting hospital employment.

Now, to carry this all one step further, everyone should be paying close attention to the financial difficulties hospitals are facing.

As an aside, even in veterinary medicine, many practices are selling out to national corporations.

 

[beansmom]

The residents locally probably make in the low-mid- $40'sK. And really, a yearly salary of $150,000 divided by the number of hours a primary care physician puts in weekly isn't all that much. Consider the hours of office, hospital rounds for those who still make them, on-call availability, and non-billable documentation = way more than a 40-hour workweek.

Oh but wait...they know what they're getting into. Is that really a legitimate justification? Do people not realize how the population has changed over 20 or 30 years? Huh. When I began working as a nurse, cataract patients stayed in the hospital for a week and slept on the opposite side of their surgery. If people had told me then that I'd see what's going on now, I'd never have believed them.

THANK YOU. My husband is a physician who does NOT make half a million dollars a year....far from it. And he is ALWAYS on call for his patients. It is a RARE night or weekend that he signs out to another doctor. Now, take the number of hours in a year and divide his salary by it...it doesn't pay enough. He has to be "alert" and make life/death decisions even in the middle of the night, even when HE is trying to relax a bit, even during dinner or even when he's in the bathroom. He quite often doesn't get home until 7:30 or 8:00 at night and when he IS here, he is either on the phone fielding calls from nurses or other doctors or doing paperwork (he gave up office practice years ago and is now a traveling geriatric physician). He has been cursed out, threatened, and sued...by his patients AND their 'loving' families. He takes crap from the administrators and the nurses. WHY? Because he cares about his patients more than he gets annoyed by their behavior.

 

[torinsmom]

I don't know what you mean...."that Doctors are no different"....I think that physicians completely get that they are in a competitive world and that's why some of the best docs are going to this model where they are able to make more money and limit their practice....which also enables them to provide better care. And that's why many are dropping medicare patients as they see that they can no longer earn a decent living with medicare reimbursements falling.

I was responding to what someone else said about doctors not knowing what they were getting into when they were going through medical school. What if other professions could just drop part of their clientele because they took more time and provided less income? Maybe I could just refuse to teach kids who do not speak English or those with IEPs, you know? Serving those students takes away from other students time and education. And there are some who don't pay taxes, so they aren't helping to support me.

I hate to think my dad is getting a lower standard of care b/c he is on Medicare. He has worked his whole life(still working part time at 70) and paid taxes, and now when he needs care, he is turned away? Very unfair.

I'm not saying any of this is the doctors' fault. Its just a fact of life with the way the economy is these days. I work 2 jobs and I couldn't afford it if my doctor were to this type of system.

 

[ssawka]

OP here, I just wanted to thank everyone for taking part in this discussion. Ultimately I know it is a business decision and not one that can be made lightly. I know the changing health care in this country is a tough pill to swallow (pardon the pun). It just scares me that ultimately it will be a person’s wallet that determines the kind of health care they get and ultimately how long they live. I know the doctors are just trying to run a business and that involves some tough decisions. It's just sad that we have all of this medical technology and still can't figure out a way to get it to everyone. I know the country is aging and there will be tough choices, it's just aggravating that we already pay so much for health care and now we are being asked to pay more. Again, I thank you for taking part in this discussion, and though we may not agree I feel these are important discussions to have.

 

[fkj2]

I was responding to what someone else said about doctors not knowing what they were getting into when they were going through medical school. What if other professions could just drop part of their clientele because they took more time and provided less income? Maybe I could just refuse to teach kids who do not speak English or those with IEPs, you know? Serving those students takes away from other students time and education. And there are some who don't pay taxes, so they aren't helping to support me.

There are many professions who refuse clients for one reason or another. As for providing less income, try not paying or slow paying a mechanic and see how fast your car gets serviced the next time.

And, for those who don't pay taxes not helping to support you, people like me who don't have children in the system will make up for them.

 

[fkj2]

It just scares me that ultimately it will be a person’s wallet that determines the kind of health care they get and ultimately how long they live.

To some degree that statement is true but it's really aggravating to try to instruct patients and families and then have them go and do (or NOT DO) whatever they want. Diabetic? Oh, I don't think I can check my blood sugars. It'll hurt sticking my fingers. Smokers? Oh, I enjoy smoking. Obese? Just sit some more. Got a Lindsey Lohan problem? Just keep peddling it to the court. Ridiculous.

It is beyond fathom how much money is wasted or defrauded from the system.

That's what frosts me. We could do so much more if everyone would just step up and discipline themselves to save a buck here so we could maybe spend it there but some people have to abuse the system at others' expense.

 

[Lewisc]

Many of us are insured by a plan that gives us coverage through a network of participating doctors. Those doctors have agreed to accept a negotiated fee. The insurance company pays that fee, less the copay which is paid by the insured/patient.

There is a question if a doctor is entitled to charge those patients a membership fee.

Not a problem if a doctor doesn't need those patients.

 

[disney11fan]

like the dr. isen't making enough money. is this what obama care has brought us. tax union benefit health care package starting in 2018. i have never heard of any dr. doing this. maybe a call to the local newspaper or your tv action reporter is needed.

good luck ...by the way when is going to start this.

 

[vicki_c]

OP here, I just wanted to thank everyone for taking part in this discussion. Ultimately I know it is a business decision and not one that can be made lightly. I know the changing health care in this country is a tough pill to swallow (pardon the pun). It just scares me that ultimately it will be a person’s wallet that determines the kind of health care they get and ultimately how long they live. I know the doctors are just trying to run a business and that involves some tough decisions. It's just sad that we have all of this medical technology and still can't figure out a way to get it to everyone. I know the country is aging and there will be tough choices, it's just aggravating that we already pay so much for health care and now we are being asked to pay more. Again, I thank you for taking part in this discussion, and though we may not agree I feel these are important discussions to have.

I'm glad you posted - I've found the entire topic and everyone's different opinions one of the more interesting topics on the budget board lately.

 

[vicki_c]

like the dr. isen't making enough money. is this what obama care has brought us. tax union benefit health care package starting in 2018. i have never heard of any dr. doing this. maybe a call to the local newspaper or your tv action reporter is needed.

good luck ...by the way when is going to start this.

You need to actually READ the thread - you will see it's not overall a new thing. There is no merit to calling the TV stations. And don't make it political or the thread will be shut down.

 

[dvcgirl]

I was responding to what someone else said about doctors not knowing what they were getting into when they were going through medical school. What if other professions could just drop part of their clientele because they took more time and provided less income? Maybe I could just refuse to teach kids who do not speak English or those with IEPs, you know? Serving those students takes away from other students time and education. And there are some who don't pay taxes, so they aren't helping to support me.

I hate to think my dad is getting a lower standard of care b/c he is on Medicare. He has worked his whole life(still working part time at 70) and paid taxes, and now when he needs care, he is turned away? Very unfair.

I'm not saying any of this is the doctors' fault. Its just a fact of life with the way the economy is these days. I work 2 jobs and I couldn't afford it if my doctor were to this type of system.

Well, there's a difference.... As a teacher, you're paid 100% with taxpayer money and as such, need to follow guidelines set by a governing body. Physicians agree to accept medicare reimbursement amounts for care if they agree to take medicare patients, but many docs are deciding to drop medicare patients altogether as they're finding that to keep them is damaging to them financially.

I guess you would have the option to teach only English speaking children if you used your degree to open your own business and tutor children in a specific subject.

I think that the reason this concierge type of model in delivering care is striking up a heated debate is because of medicare, and also because people think that physicians should put patients first, even if that means economic suicide.

Then there's this idea, "well, they knew it would cost hundreds of thousands of dollars.....now they're complaining about what they make....too bad". But it doesn't have to be "too bad" for them ....many have found a way to monetize their exemplary care.

 

[kaytieeldr]

like the dr. isen't making enough money. is this what obama care has brought us. tax union benefit health care package starting in 2018. i have never heard of any dr. doing this. maybe a call to the local newspaper or your tv action reporter is needed.

good luck ...by the way when is going to start this.

Heck no. Concierge doctors were around long before this health care plan.

 

[kaytieeldr]

like the dr. isen't making enough money. is this what obama care has brought us. tax union benefit health care package starting in 2018. i have never heard of any dr. doing this. maybe a call to the local newspaper or your tv action reporter is needed.

good luck ...by the way when is going to start this.

Heck no. Concierge doctors were around long before this health care plan.

 

[stitchlovestink]

THANK YOU. My husband is a physician who does NOT make half a million dollars a year....far from it. And he is ALWAYS on call for his patients. It is a RARE night or weekend that he signs out to another doctor. Now, take the number of hours in a year and divide his salary by it...it doesn't pay enough. He has to be "alert" and make life/death decisions even in the middle of the night, even when HE is trying to relax a bit, even during dinner or even when he's in the bathroom. He quite often doesn't get home until 7:30 or 8:00 at night and when he IS here, he is either on the phone fielding calls from nurses or other doctors or doing paperwork (he gave up office practice years ago and is now a traveling geriatric physician). He has been cursed out, threatened, and sued...by his patients AND their 'loving' families. He takes crap from the administrators and the nurses. WHY? Because he cares about his patients more than he gets annoyed by their behavior.

God Bless Him!!!