doing OB only

[aggiecrew]

ok I have a few questions..

1. is it possible to just do straight OB with no gyn whatsoever after residency? I know this wouldn't be the most desirable thing to do for most people but I'm curious, do people do this?

2. with malpractice so high, can't private prac ob's just raise their rates to compensate? if you could say they'd have no more patients, but I heard that it's actually hard to keep people in the profession, so it seems like there would be a lot of people needing to see an ob.

3. I've read about horrible hours for ob's, but couldn't private prac ob's just take less patients for less money? you could say that they'd make no money since malpractice premiums stay at the same high level despite patient load, but that's why I was asking above about increasing rates.

4. do ob's ever screen out even medium-risk patients and only take low-risk patients?

thanks!

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[starayamoskva]

ok I have a few questions..

1. is it possible to just do straight OB with no gyn whatsoever after residency? I know this wouldn't be the most desirable thing to do for most people but I'm curious, do people do this?

2. with malpractice so high, can't private prac ob's just raise their rates to compensate? if you could say they'd have no more patients, but I heard that it's actually hard to keep people in the profession, so it seems like there would be a lot of people needing to see an ob.

3. I've read about horrible hours for ob's, but couldn't private prac ob's just take less patients for less money? you could say that they'd make no money since malpractice premiums stay at the same high level despite patient load, but that's why I was asking above about increasing rates.

4. do ob's ever screen out even medium-risk patients and only take low-risk patients?

thanks!

1.Of course it is possible to do just OB in your practice after you finish residency. You can tailor your practice any way you want to. You might want to consider an MFM fellowship if OB is your intended focus.

2. While this seems to be a good idea in theory, in reality you are not in complete control of what you charge. Most insurance companies and medicaid/medicare have a set amount that they pay for specific services. So you can "charge 300$ for an office visit but that doesn't mean that you will get reimbursed that amount your patients insurance.

3. See above. A better solution would probably be to join a large practice so you have fewer nights that you are on call.

4. Again, you can do whatever you want in your practice.

 

[aggiecrew]

thanks for your response!

so could ob's choose to be 100% cash and carry only? I've heard of some psychiatrists doing this and of course plastic surgeons do this all the time. do any private practice ob's ever just skip the insurance stuff and run practices that are like plastic surgery practices but exclusively for pregnancies? anyone ever heard of this?

thanks!

 

[Jules1231]

I know of one practice that charges cash up front for everything and then the doctor turns in the insurance paperwork but the insurance company pays the pt not the doctor. (aka the doctor always gets what they charged)
This of course would only work in an area where people have lots of money.

 

[jbish]

I know of one practice that charges cash up front for everything and then the doctor turns in the insurance paperwork but the insurance company pays the pt not the doctor. (aka the doctor always gets what they charged)
This of course would only work in an area where people have lots of money.

This is how every dentist I have ever been to worked. I wonder why people are willing to do that for their teeth but not other parts of their bodies. This also reminds me of a professor I had in college who was appalled by the fact that people would spend more money on their pets than on their own health care.

 

[aggiecrew]

I know of one practice that charges cash up front for everything and then the doctor turns in the insurance paperwork but the insurance company pays the pt not the doctor. (aka the doctor always gets what they charged)

so would the insurance companies be ok with this? my guess is that this would only work if the insurance plan was a 90/10 and not a co-pay?

thanks for the response!

 

[doprogressive]

There are a lot of new options for OBGYN practices becoming available right now. I believe this is because a lot of women entering the field feel they put off their personal lives for medical training and now want them back. There are places hireing hospitalist OB's (shift work), there are huge practices that distribute the call so much that many people are on call like one or two times a month. Very few people can say that they personally deliver all of their patients: the system rarely can work that way. There are subspecialties like pelvic floor reconstruction, urogyn, maternal fetal medicine (high risk obstetrics), family planning. These allow more specialized schedules with the more specialized feild. As for the reimbursement, OBGYN is one of the only primary care fields where reimbursement is plateauing-off, not drastically dropping. There are Nurse Practictioners and Midwives you can hire in your practice to help cover you at your office if you need to go to a delivery or help you cover or field your call. With the influx of women into the profession, OBGYN will only get more flexible and liveable. In several years according to Reutgers, there will be a shortage of physcians, think how big of a percentage will be OBGYNs. With good training, you'll be able to go anywhere and name your price in 10-15 years (right at the height of our careers). The patients will always be there and the malpractice will have to change. I think its a great field to get into. However, doing just OB may get a bit boring.

 

[Jules1231]

so would the insurance companies be ok with this? my guess is that this would only work if the insurance plan was a 90/10 and not a co-pay?

thanks for the response!

I just heard about it in passing. I'm not exactly sure how it works out with the insurance companies.

 

[jdog]

I just heard about it in passing. I'm not exactly sure how it works out with the insurance companies.

In response to earlier question about cash upfront, I don't see how this would work for OB/GYN. For example, what if you pay up front for a delivery, then it ends up in a C-section, then there is blood loss so you need blood, then you need an ICU bed, etc. That would be tens of thousands. Who the hell is going to pay that out of pocket.
Cash is fery feasible for plastics and dentistry because a lot of this stuff is elective and insurance won't pay anyway.
The fact is that most people who can afford to pay up front already have health insurance, so why would they pay cash when their insurance will pay??????????????/

 

[Jules1231]

This practice is in a very rich community in Florida. Of course everyone has insurance. Sometimes insurance companies will pay the hospital costs, etc but they end up not reinbursing doctors on things like time cost, etc (the doctor's fee). This is just the way this practice is getting around that. The pt pays the total cost and insurance company then pays the patient. I also heard most of these deliveries are "scheduled". For example, the lady wants her baby at 10am on Tuesday b/c that's when her nanny will be flown in from Mexico, etc. I am not sure what scheduled means-maybe it's a scheduled section. If I have a chance to talk to the resident who is joining that practice in June, I'll ask her about the paying for a delivery and then having a c-sxn, etc. I thought that was a pretty good question-and I have no idea what the answer is.