wait what?? even charity care is possible??? so academic physicians can care for uninsured patients??? that would be great!!!!
It's not great as it's providing a service, anesthesia, surgery and post op care for example, with full liability (w/ potentially higher risk of suits for any issues) and zero income to the group/hospital.
So you work in academia? Most of your patients have "real" insurance?
Salary wise, don't academic physicians take a hit because of this?
In general salaries are lower in academia, not always lower than the PP average though. More uninsured and medicaid in general means a lower income, though hospital stipends can fix this to some degree. There can also be a significant difference between faculty rank. It's very hospital dependent.
From all of the doctors that I shadowed all of them were getting tired of not getting reimbursed by medicaid. Especially since I come from Alabama where unfortunately there are a lot of medicaid patients. I'm not sure how I feel about this to be honest.
Medicaid pay is bad, horrible for anesthesia. 1/2 the rate the surgeons get. It needs congress to fix it, and has been proposed several times as unfair w/ congressional support. Not passed yet.
🙁 maybe never.
Many academic medical centers run free clinics and similar projects; they also take Medicaid. These centers can do this with the help of Graduate Medical Education funding (and, though I am unsure, may be obligated to).
As academic physicians are salaried -- ie they get payed a set salary by the school and hospital -- their income is not determined directly by insurance reimbursement.
Academic physicians do, however, make less. On the other hand, from my understanding, there are other perks: less clinical hours/potentially less hours overall; many academic institutions give a stipend to faculty to help pay for their kid's college education; 401K and other retirement benefits; having things that many see as potential hassles -- ex, malpractice insurance -- handled for you; etc. You also often tend to see more rare and interesting cases, get to be a part of clinical research (including trying new treatments) and you are involved in teaching residents/fellows, if you are interested in that.
IlDestriero, feel free to correct anything I am saying that may be inaccurate.
Many benefits/perks, often better hours, academic/admin time, etc. Salary for hours worked might not be that bad depending on the job. It's very variable. Academic anesthesia jobs I've looked at ranged $225 - >$500, before benefits. In general, the more you work, the more you make. PP will usually pay better for full time work, though partner track folks could certainly make less until they make partner. PP can also have more vaca. All very variable. I've seen academic jobs w/ 5-9 wks vaca and PP w/ 6-15 wks. The other stuff you noted is true and very valuable to me, others would disagree. Being on the tip of the spear in developing new techniques, etc is amazing. Many (most?) academic surgical jobs have incentive compensation for what they're bringing in and can do very, very well.
Just to clarify - most academic medical centers do not accept uninsured patients in their outpatient clinics.
ED visits and inpatient hospitalizations are a slightly more complicated issue. If an uninsured patient comes to the ED, they will be seen and treated regardless of their ability to pay. Similarly, if they are ill enough to require admission, they will be admitted to the hospital and treated. However, the hospital will typically expect to be paid for these services (often at a reduced rate or on a monthly payment plan). That said, many (if not most) uninsured patients who come to the ED and/or get admitted end up defaulting on their hospital bills, so this too, in essence, becomes charity care.
I suspect that the charity care people are referring to above is more along the lines of physicians volunteering their time in independent free clinics. These opportunities exist for both academic and private practice physicians.
Correct. Sometimes the hospital board will approve complex cases that others can't/won't do knowing they won't get paid. Examples would be complex Peds hearts, conjoined twin separation, unique cases, etc.
