Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, September 26, 2006

Still More About Money

More with the comments:
OK, so you're a good doctor and you are smart. Here's a test for you... do you make more money seeing patients or analyzing reimbursement from certain payors?

I know lots and lots of very astute business people who are also physicians. My wife is one of them. The reason they are good business people is that they realize where they make money... in the exam/treatment room.

Hire someone who is good at watching over things, stay in the loop, but generate more revenue and you'll be happier and more financially successful

How the hell am I supposed to "hire someone" when I can't even pay myself!

What you don't seem to grasp is that there are places in this country where a completely optimized medical practice still doesn't generate the kind of revenue you're talking about. It is a myth that if a practice isn't doing well, it's the doctor's fault for either not working hard enough or smart enough. "Just get into that exam room and see more patients" = "Why can't they eat cake?"

Again, an apparent solution would be "so move." But doctors are not fungible; a commodity easily interchanged by physician recruiters (oh, lookie: another lucrative middle-man industry that doesn't actually provide healthcare.)

There is more to business than being astute. Perhaps one could say that my only bad decision was in setting up practice in an area like this, but as it happened when I began the practice it wasn't like this. The environment (the BUSINESS environment) is what has deteriorated over the years. This is not the kind of thing that even business people can predict (though now that I think about it, they're the ones who caused it.) What they can do, though, is move on to other industries, whereas I'm "stuck" because there are 2000 people here I care about and who need me.


At Tue Sep 26, 08:50:00 AM, Blogger Big Lebowski Store said...

I left a huge thoughtful comment that blogger friggin' lost.

It was about thinking outside the box. Sorry. Maybe later.


At Tue Sep 26, 09:43:00 AM, Anonymous Anonymous said...

"What they can do, though, is move on to other industries, whereas I'm "stuck" because there are 2000 people here I care about and who need me."

You aren't stuck. You are making the right decision based on your values. And I bet you can sleep at night . . .

I agree with you--greedy people tend to mess things up everywhere they go. *sigh*


At Tue Sep 26, 11:56:00 AM, Anonymous Anonymous said...

Stop caring about your patients, and start caring about your family. It's not easy, but it's worth it.

At Tue Sep 26, 12:17:00 PM, Anonymous Anonymous said...

So, the business climate changes in your community and with great consideration and thought, plants are closed, people are affected, etc. Your business is the same.

I feel that you have to choose to either fulfill what you feel is your mission to treat those 2000 people at whatever personal cost or move someplace else and take care of a different 2000 people who will actually pay you. Some businesses choose to try to make profits, others choose to serve the community (charities).

You seem reluctant to move and feel that physicians aren't "fungible" but, right or wrong, it happens everyday all over the US.

You do have a choce in the matter though.

At Wed Sep 27, 10:18:00 PM, Anonymous Anonymous said...

Everyone is replaceable when they are not making a whole lot. Once you are paid what you think you are worth that's when you move more towards the irreplaceable realm. Those 2000 people will find someone else to treat them and you are more likely to have more satisfaction by working less and making more in another market.


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