In the real world a patient will drop that Harvard Doc in a heartbeat if he would have to pay a $10 copay. Happens to my friends in primary care all the time. A patient of 20 yrs gets new health insurance for any reason and leaves the practice because the Doc is now out of network resulting in a new $20 copay
THIS^^^^^^^^^. Although, you should know, on the other end of the bill, the big difference isn't the new copay. It's the large amount the practice agrees to write off in order to be in the network. A $150 charge might be written down to $70 in network, where the patient then has a $10 or $20 copay, with the insurance company paying the balance. Going out of network is not just an additional $10 copay, it also means being responsible for the $80 difference in the service charge, which the practice is no longer obligated or willing to write off, and which the insurance company won't cover.
THIS adds up over time, which is why private practices are going to way of the dinosaur, since you need critical mass to be able to negotiate those in-network reimbursements with the insurance companies and because, in today's world where insurance premiums are so high, patients are unwilling to pay them AND pay out of network fees, in addition to copays, deductibles, etc.
And, yeah, this is why where you go to school or train doesn't matter, because nobody, nowhere, is willing to pay a premium for it, other than, apparently, some proud parents who think it means anything once you go outside academia. Whatever.
Top tier schools are still preferable if you want a better shot at some residencies, or want a job in academia. But again, the parents arguing here because they want it to be true are kidding themselves if they think a Harvard trained clinician makes any more than any other clinician in the same specialty, in the same practice group, in the same geographic area with the same level of experience and productivity. The system just doesn't value or reward pedigree at that point.
Pedigree is important, MAYBE, in making it to a given specialty, but is meaningless in the real world in terms of compensation once you are there. In the real world, people hire people based on whether they want to work with them, not based on where they went to school, because there is no way to monetize that, so it just doesn't add value to the practice.
Nice people with a good bedside manner who are good at their jobs generate business, no matter where they went to school. And arrogant d-bags, or people who suck at their jobs, turn patients and coworkers off, again, no matter where they went to school. All types are found at all schools. So why does anyone think fancy schools are determining factors regarding being hired, or compensation, in an industry with a chronic shortage of caregivers?
We keep seeing posts and hearing about people who don't match. Who actually has a hard time finding work post residency, and, to the extent they even exist, are they really disproportionately coming from low tier schools, because first dibs go to people at fancy schools???????????? I'd imagine the dick coming out of Harvard and interviewing for jobs would have the same results finding work that the dick applying to Harvard with a 4.0/528 would have on the way in to school, and the same would be true for the rockstar coming out of a low-tier state school.
