Doctors retiring

[davesl708]

ERs are not created equal. And I didn't say they'd get good care, just care. Mandatory health care in ERs is also why hospitals close them or provide poor care except for the true emergencies. ERs, as a hospital department lose money.

Sadly, people equate health insurance with health care. They also use the word 'free' when what they really mean is 'someone else pays'.

True. Sad but true.
I am just very lucky I have good health so far. Have not had any need for doctors.

 

[dmccarty]

Government regulation is pushing the small local doctor practice to work for big companies. Hospitals in my area have been consolidating for years and this really accelerated in the past few years. We no longer use the doctor's office we have gone to for 10 years because they are part of a large "company" and the doctor turnover was pretty high. What broke the camels back was my wife went to the office to get a short of an overseas trip. I went to the same office for the same reason but I was billed several hundred dollars for a "consultation" vs a shot. We could not get the office to change the billing. Obviously, some nim rod in the office wrote down the wrong code but they could not/would not change the billing. Fine. We can, at least for now, change doctors. <Insert Middle Finger Emoticon> :laughing::laughing::laughing:

The current doctor is an old "country" doctor. I doubt we will be with him long before he retires. He is what a doctor SHOULD Be....

We used to go to a really good bone cracker but we stopped going to him because his billing was a mess. :confused2: The office just could not get the bills right. We could never tell if this was because he was too cheap to hire competent staff or if the administrative overhead forced him to try to do the work himself. He was CONSTANTLY complaining about paperwork and how he wanted to go work for a larger practice that could afford people to handle the paper work. I think this is the new normal for doctors AND patients. My wife was working on health care bills last night and she makes at least one call a week to service providers about billing issues.

Unfortunately, we have quite a bit of experience with the health care system. The billing sucks and it is getting worse. I am not talking about costs, just dealing with the paperwork. Most of our billing issues are in the doctors offices and not with the so called evil insurance companies. In fact, we have a contact at our insurance company that helps us out when things go bad. We have constant billing issues with the service providers and we have had ID theft from one doctors office.

It is apparent that government regulation is pushing for a consolidation of service providers into ever bigger organizations while more revenue is given to insurance companies under Obama Care.

What is ironic is reading about people cruising the world, in out of the way places, getting good quality health care for very little money when they need the care. The health care quality is good, service fast, and prices reasonable if not cheap.

Later,
Dan

 

[MikePA]

Please quote your source for 'more and more revenue is going to insurance companies.'.

States who set up exchanges got money for Medicaid, for a few years.

Unions and other entities got money to help people sign up.

I am not aware of any insurance company who received money, in fact I have heard some insurance companies are losing money on ACA and will be cutting back on what they offer.

 

[dmccarty]

Please quote your source for 'more and more revenue is going to insurance companies.'.

States who set up exchanges got money for Medicaid, for a few years.

Unions and other entities got money to help people sign up.

I am not aware of any insurance company who received money, in fact I have heard some insurance companies are losing money on ACA and will be cutting back on what they offer.

It is self evident that insurance companies are getting more revenue from premiums because there are more people insured by Obama Care. NC BCBS lost money on Obama Care policies and they are asking for something like a 25-35% increase in premium costs for next year. Thus more revenue. Revenue is not profit. Not yet at least, but once they figure out the the correct expense/premium ratio, the higher revenues will likely lead to higher profits. NC BCBS had a 20-25% increase in revenue in 2014 but Obama Care policies spent 40%ish more than non Obama Care policies and this caused NCBS to loose money. NC BCBS lost money but increased revenues because of Obama Care policies. The Obama Care policies extra costs were for visits to the ER, special drugs for Hep C, and for some strange reason, double the amount of Orthopedic care.

All of this was reported in our local news, though certainly not on the front page. The NC BCBS report is here Blue Cross Blue Shield of North Carolina Reports Financial Results for 2014 | Blue Cross Blue Shield North Carolina

Later,
Dan

 

[buickanddeere]

Think that is bad. Our rural municipality of Kincardine with 12,000 persons is loosing four physicians this year.

 

[Will_C]

For every action, there is a reaction. What we starting to see is the reaction to Obama care. Make the medical profession subject to income reduction and more complications, the supply and quality dries up.

Will

 

[Fawken]

The hospital I work at is busier than ever. No idea if they're making money or not. They've been bought out so many times I stopped counting (twice this year alone). Here are the things that have added tons of paperwork:
(1) HIPPA Compliance.
(2) Vendor tracking (a part of Obama Care)
(3) Double the insurance filings (also due to Obama Care)
(4) Computerized dispensing and inventory of pharms and consumables (a part of Obama Care to cut out waste)
Those are just the ones that come to mind. The doctors I talk to are making less and working more.

 

[Danno1]

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Don't forget the cost of malpractice insurance. This is a large bill for all doctors.




.

 

[brown40]

When it will become really terrifying is when providers get paid for your health maintenance--the more you use it the less their return. We are seeing the shift from 'do more to get paid more', to 'do the same to get paid less'. Next will be 'get paid less for not doing more'. Then the care system that offers the service will be as motivated as the insurers to resist providing the service. Only in this country could something essentially very simple and easily measured by customer satisfaction be made into a overly-complex system with dissatisfied providers and consumers littering the construct.

 

[Gator6x4]

ICD10 codes get rolled out on 10/1. There are about 14000 icd9 billing codes and 70000 icd10billing codes. Get a code wrong and .........
We get hammered all the time about insurance denials for what we bill in the Physical therapy dept. Of a state hospital. As far as non coverage, I work in a rehab department and my insurance would not cover many of the things we bill for every day

ICD Coding personal are in high demand, and command a high salary. Medical practices that don't want to modernize to the electronic age will have problems. The computer programs used by Primary Care Doctors are rather sophisticated. The Doctor enter the information on his examining room computer and information is sent to the patients record, billing, lab etc.

 

[milkman]

Two specialist doctors I have been going to for the last ten years or so are retiring. One is an Urologist, the other a Podiatrist. Both had told me a year ago that they couldn't retire for several years. Both told me that they would have to hire at least one more office worker to keep up with the extra paperwork the government is giving them. So now one is gone and the other going in a week or two.

I saw my GP yesterday (allergy sinus infection, they are picking corn all around us). He graduated High School the same year as me. He has said before that he would work a minimum of four more years until he was sixty-five. I always get on him because I retired before sixty. Yesterday he said that it might not be that many more years until he retired. Said he was seeing more patients than even but his income had dropped to around 60% of what it was ten years ago. He did have three nurses who took patients back and checked them out. Now he has four nurses with two checking patients and two sitting doing paperwork and on the phone all the time.

My new Podiatrist is young, female, went to school with my daughter, and talks constantly. She said she doesn't know how long it will take her to pay off her loans. Said she loves the work but is not making near the money she thought she would. Said she was making a lot less than the older doctors told her she would when she started thinking about a medical career.

Now, are they pulling my leg about the added paperwork?

Why would a doctor who has so much business that he doesn't take new patients be making less money? Are they misleading me about that?

Are doctors making that much less money than say ten years ago?

Just wondering.

RSKY

The making less money thing, I've been on SS since 2004 and I'm making less than I was 10 yrs ago also.

 

[Dr_Zinj]

Now, are they pulling my leg about the added paperwork?

Why would a doctor who has so much business that he doesn't take new patients be making less money? Are they misleading me about that?

Are doctors making that much less money than say ten years ago?
RSKY

<b>"Now, are they pulling my leg about the added paperwork?"</b>

No, they are NOT kidding abou the added paperwork. You can blame the Federal and State governments, and the insurance agencies for that. And it doesn't matter if it's a paper form, or a computerized form; doctors, PAs, NPs, healthcare office staff are ALL spending more time feeding the information monster. Many physicians ratio of patient time to paperwork time is 1 to 9 or worse. And it is NOT getting better under Obamacare.

<b>"Why would a doctor who has so much business that he doesn't take new patients be making less money? Are they misleading me about that?"</b>

See above. If you're a farmer, and you were spending 50% of your time in the fields and barns with crops and animals, and 50% of your time on tax paperwork, and your tax paperwork increased by 20%, where's the time going to come from? Sleep? Ha! It's going to cut into your actual time farming, which means less money.

<b>"Are doctors making that much less money than say ten years ago?"</b>

I retired from the military and got a private job in 1999, and remember gasoline being a dollar a gallon. Gasoline quadrupled in price and even now is a bit over $2 a gallon. I guarrantee my paycheck hasn't doubled in that time, much less quadrupled. Interesting enough, buying power of the dollar has dropped about 50% since 2000, which is in line with the $2 a gallon gas bit, for now. So, to apply this to doctors. In Dollars, they're making more than ever before, in actual value, they're in the same boat as the rest of us, only having half the buying power of their take home pay. That excludes those specialties that have undergone massive increases, such as good plastic surgeons, who's demand, and pay, have skyrocketed.

 

[sseelhoff]

<b>"Now, are they pulling my leg about the added paperwork?"</b>

No, they are NOT kidding abou the added paperwork. You can blame the Federal and State governments, and the insurance agencies for that. And it doesn't matter if it's a paper form, or a computerized form; doctors, PAs, NPs, healthcare office staff are ALL spending more time feeding the information monster. Many physicians ratio of patient time to paperwork time is 1 to 9 or worse. And it is NOT getting better under Obamacare.

<b>"Why would a doctor who has so much business that he doesn't take new patients be making less money? Are they misleading me about that?"</b>

See above. If you're a farmer, and you were spending 50% of your time in the fields and barns with crops and animals, and 50% of your time on tax paperwork, and your tax paperwork increased by 20%, where's the time going to come from? Sleep? Ha! It's going to cut into your actual time farming, which means less money.

<b>"Are doctors making that much less money than say ten years ago?"</b>

I retired from the military and got a private job in 1999, and remember gasoline being a dollar a gallon. Gasoline quadrupled in price and even now is a bit over $2 a gallon. I guarrantee my paycheck hasn't doubled in that time, much less quadrupled. Interesting enough, buying power of the dollar has dropped about 50% since 2000, which is in line with the $2 a gallon gas bit, for now. So, to apply this to doctors. In Dollars, they're making more than ever before, in actual value, they're in the same boat as the rest of us, only having half the buying power of their take home pay. That excludes those specialties that have undergone massive increases, such as good plastic surgeons, who's demand, and pay, have skyrocketed.

This is correct, but also overlooks the corporatization of medicine. More and more practices are owned by corporations. The practice of medicine, once directed by doctors who has the primary goal of providing patient care, is now driven by profit seekers. Same thing has happened to the other professions. It used to be the professionals were about providing a service, and the business aspect was an adjunct. Now the profit is the goal, and the provision of service is just a means to that end.

 

[oldballs]

Yeah, I've been in the medical industry. I've seen hospitals bought out by corporations. Little county hospitals are merged into the group. The doctors who used to have some say so in the operation, as well as a vested interest, have now become just another employee. They don't have much to say about the operation of their individual specialties in such hospitals. The inner city hospitals have gone broke or moved to the suburbs.

And hospitals and doctors that have their rightful moral codes are forced to bow to the government policy, or close up.

Years gone bye, the lower classes (us....me) got good medical care by the physicians, clinics and the hospitals. The hospitals and doctors were respected and gave their best to all of us.....without the government mandates.

As far as I'm concerned.......today the whole system sucks.....even though there are still some good docs out there in general practice.

Cheers,
Mike

 

[ultrarunner]

We have seen a rash of Docs retiring... they simply no longer enjoy what the medical world has become... and it is not just medical... anyone that is an employer with a small staff knows how things have changed.

My sister in law gave up her practice in the big city... overhead was just too high and she found as a Doctor/Employer... it was all on her.

She is much happier with a very small office and one part time employee she shares in a suburban setting.

Reimbursements continue dropping and there are cases simply not worth it anymore.

The older Docs remember what medicine was and many are not willing to go back to square one.

The younger ones are gravitating towards HMO where they are employees... no stress or burden of running an office, hiring and firing, etc.

Change was promised and change has happened.

I do not know a single Doc I work with that has encouraged his or her child to go into medicine... not one... most of the new Docs are foreign born and so are many of the RNs...

And yes... it can take many months or even more than a year to get paid... and then often less.

I have the same Dentist for years... every year work changes Health Plans because the premium increases is double digit... so every year it is new billing and new deductibles, co-pays, exclusions, limits etc...

The Dentist still has not been paid the $80 billed 11 months ago.

One of our Docs has 3 sons... his oldest is 30 years old and sell commercial Real Estate... said he started earning more than the old man at age 27 and has almost zero overhead... no staff, no employer issues... no OSHA visits, no Disaster Plans, No Hazmat Certifications, No all encompassing continuing education and re-certifications...

It is a perfect storm stacked up against the small providers on several levels... and this is based on my 25+ years in the medical profession.

 

[300UGUY]

We have seen a rash of Docs retiring... they simply no longer enjoy what the medical world has become... and it is not just medical... anyone that is an employer with a small staff knows how things have changed.

My sister in law gave up her practice in the big city... overhead was just too high and she found as a Doctor/Employer... it was all on her.

She is much happier with a very small office and one part time employee she shares in a suburban setting.

Reimbursements continue dropping and there are cases simply not worth it anymore.

The older Docs remember what medicine was and many are not willing to go back to square one.

The younger ones are gravitating towards HMO where they are employees... no stress or burden of running an office, hiring and firing, etc.

Change was promised and change has happened.

I do not know a single Doc I work with that has encouraged his or her child to go into medicine... not one... most of the new Docs are foreign born and so are many of the RNs...

And yes... it can take many months or even more than a year to get paid... and then often less.

I have the same Dentist for years... every year work changes Health Plans because the premium increases is double digit... so every year it is new billing and new deductibles, co-pays, exclusions, limits etc...

The Dentist still has not been paid the $80 billed 11 months ago.

One of our Docs has 3 sons... his oldest is 30 years old and sell commercial Real Estate... said he started earning more than the old man at age 27 and has almost zero overhead... no staff, no employer issues... no OSHA visits, no Disaster Plans, No Hazmat Certifications, No all encompassing continuing education and re-certifications...

It is a perfect storm stacked up against the small providers on several levels... and this is based on my 25+ years in the medical profession.

I suspect that the perfect storm that is hitting the medical field is the same storm that has hit the rest of us for years. With incomes declining or stagnant, people simply have less to spend on medical care. Maybe the medical folks have been sheltered to some extent?

 

[ultrarunner]

In some ways the answer would be yes... very hard to offshore medical care... although many have tried... like having your scan read by radiologist in India...

The last 5 to 7 years have been a real struggle... and the cuts keep coming... yet, overhead increases never stop which covers everything from electricity to drugs and medical supplies...

I remember growing up without Medical Insurance... my parents paid out of pocket for everything... any Doctor's office would accept installments for larger amounts.

When Dad bought a Hospital Plan it only covered the kids and was quite reasonable...

Change is stressful and more so for older people... at least this is my experience.

Doctors have gone from being the captain of their ship to employee status subject to one directive after another from insurance companies and now the government...

My very good friend is also thinking of calling it quits... he is also a tractor guy...

His patients are usually very sick and it can take months to get procedures approved... the files sometimes look like stacks of telephone books for one patient.

It frosts him to no end to have none medical professionals making life or death decisions and he goes to the mat for his patients... but it is really starting to take a toll on him... often I seen him in his office to 10 o'clock at night and the next morning he is in the operating room at 7 am...