Radiology reimbursement in PP

[fedor]

In many specialties (such as dermatology), partners compensation often derives from a percentage of collections that they individually bring in.

However, I would imagine that this compensation system would fail in radiology because it would create a huge incentive for radiologists to cherry pick the higher reimbursing scans (such as MRI) while avoiding the ones which reimburse little (chest X-rays).

Thus, how are radiologists in private practice dealing with this? Is 1) compensation not based on individual collections, or is it 2) based on individual collections but there is a system established to fairly allocate cases so one individual doesn't get all the best ones?

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[hans19]

In many specialties (such as dermatology), partners compensation often derives from a percentage of collections that they individually bring in.

However, I would imagine that this compensation system would fail in radiology because it would create a huge incentive for radiologists to cherry pick the higher reimbursing scans (such as MRI) while avoiding the ones which reimburse little (chest X-rays).

Thus, how are radiologists in private practice dealing with this? Is 1) compensation not based on individual collections, or is it 2) based on individual collections but there is a system established to fairly allocate cases so one individual doesn't get all the best ones?

Are you more interested in
1) radiology
2) how radiology is compensated?

 

[matthewtam2002]

Yes, I see a lot of this talk, it is very interesting: I am English, live and work in
the Uk and use this site to find out more about the American medical system
and the people who work in it.

Lots of money orientated fora. Stuff like how to reimbursed. Write a ROS
in the chart of everyone you see so you can claim it back.

Unbelievable (actually very believable).

Very interesting indeed! And you are a medical student!

 

[tigershark]

Are you more interested in
1) radiology
2) how radiology is compensated?

What do you care? Answer his question or stfu.

Does every damn post that talks about compensation have to be hi-jacked by some holier-than-thou jackass?

 

[hans19]

What do you care? Answer his question or stfu.

Does every damn post that talks about compensation have to be hi-jacked by some holier-than-thou jackass?

You have the freedom to make whatever 'jackass' post you please, and I have the freedom to respond.

Why do I care? Because its annoying when people are more interested in how much you make than what your profession means to you.

If that makes me holier-than-thou, thou canst get on thy knees and kiss my feet or STFU.

 

[2muchplanning]

Does every damn post that talks about compensation have to be hi-jacked by some holier-than-thou jackass?

I completely agree. Its this flame-happy mentality that deters people from even posting questions. Isn't one of the benefits of a message forum to anonymously ask the questions you're too timid or fearful to ask in person.

Just because fedor had a question about finances doesn't mean that's the only point of concern. Its a genuinely interesting question and provides insite into the mentality of those in radiology private practice. If someone is interested in the field shouldn't they have a right to know how it functions? Did you even consider that perhaps he was asking the question with the thought that if it was riddled with 'cherry-pickers' then perhaps its not for him. Perhaps he doesn't want to join a field where his peers are going to be more interested in getting an edge for a few extra bucks.

Either way, it was an innocent questions, you guys gotta get off your soap boxes.

 

[fedor]

Are you more interested in
1) radiology
2) how radiology is compensated?

Don't be too sensitive about radiology salaries. Everyone knows radiologists are compensated very well and the salary surveys are available widely online.

My question is specific about the way compensation is handled in private practice not about the amount of compensation itself. If you have nothing to add to this discussion, then kindly STFU.

 

[tigershark]

You have the freedom to make whatever 'jackass' post you please, and I have the freedom to respond.

Why do I care? Because its annoying when people are more interested in how much you make than what your profession means to you.

If that makes me holier-than-thou, thou canst get on thy knees and kiss my feet or STFU.

What exactly about his post implies he is more interested about compensation than the field? If you can point it out I would gladly apologize.

Otherwise it looks like you were simply projecting your own insecurities into a legitimate post.

 

[hans19]

For each instance of 'compensation' you identify in the original post, I'll give you a cookie, or if you prefer, a sticker.

If you find them all, Carlos Mencia will give you the "D'D'Deeeeeee" award.

 

[tigershark]

For each instance of 'compensation' you identify in the original post, I'll give you a cookie, or if you prefer, a sticker.

If you find them all, Carlos Mencia will give you the "D'D'Deeeeeee" award.

I see so if you talk about compensation it automatically means you have a purely financial interest in the field?

Interesting concept, so I guess that means everytime you discuss any aspect of a field you have to write a full thesis describing your thoughts and motivation on every aspect of medicine?

Are you really that stupid?

This idiotic "never talk about money" mentality is why doctors are losing control of medicine.

 

[f_w]

> 1) compensation not based on individual collections, or is
> it 2) based on individual collections but there is a system
> established to fairly allocate cases so one individual doesn't
> get all the best ones?

Many radiology groups are indeed somewhat exotic in this regard. Many of them are organized along the 'last Kolchose' concept. Everybody does his job to the best of his abilities (speed) and stays in the hospital/practice until all studies of the day are read. At the end of the year/quarter, all the collections are thrown into a pot, the overhead (manager, equipment, ancillary personnel, non-partnership radiologists) are paid and the remainder is divied up among the partners. As a result, you don't have the cherry picking you mentioned. But as a result, you will also have some slackers and no incentive for them to pull their weight (the nucs guy who sits in his office from 8.30 to 11 until the nucs studies trickle in, the group CEO who spends hours upon hours on 'administrative time' at the local golf course).

So, many groups do have some sort of incentive system. Often this is tied to 'RVU's, (the goverments way to weigh different professional services). Based on past experience, the group will set a threshold of RVUs for every partner (which might be higher for the MSK MRI reader than for the mammographer). Once the partner exceeds that threshold, he gets a share of the additional collections. Also, 'partnership' can mean a number of things. There is partnership in the professional corporation (which is typically comprised of equal shares) and partnership in the 'equipment and real-estate corporation' (where the senior partners will typically own larger shares and the new partners less).

And yes, there are 'eat what you kill' radiology groups. Everyones collections are discounted by a percentage of common overhead and the partners take home their individual share. This can work great, because nobody will look at another partner in a bad way if he chooses to leave early once in a while. But on the other hand, you can end up with 'poaching' of high revenue studies and 'dumping' of low-reimbursement (largely charity) ER and pediatric work (often these groups will end up with mandatory mammo, ER and pediatric coverage to fix this problem. Everyone has to read 30 screening mammos per day or cover the ER board for 6 hours per week)

 

[fedor]

F-w, thank you for your lucid explanation.

> 1) compensation not based on individual collections, or is
> it 2) based on individual collections but there is a system
> established to fairly allocate cases so one individual doesn't
> get all the best ones?

Many radiology groups are indeed somewhat exotic in this regard. Many of them are organized along the 'last Kolchose' concept. Everybody does his job to the best of his abilities (speed) and stays in the hospital/practice until all studies of the day are read. At the end of the year/quarter, all the collections are thrown into a pot, the overhead (manager, equipment, ancillary personnel, non-partnership radiologists) are paid and the remainder is divied up among the partners. As a result, you don't have the cherry picking you mentioned. But as a result, you will also have some slackers and no incentive for them to pull their weight (the nucs guy who sits in his office from 8.30 to 11 until the nucs studies trickle in, the group CEO who spends hours upon hours on 'administrative time' at the local golf course).

So, many groups do have some sort of incentive system. Often this is tied to 'RVU's, (the goverments way to weigh different professional services). Based on past experience, the group will set a threshold of RVUs for every partner (which might be higher for the MSK MRI reader than for the mammographer). Once the partner exceeds that threshold, he gets a share of the additional collections. Also, 'partnership' can mean a number of things. There is partnership in the professional corporation (which is typically comprised of equal shares) and partnership in the 'equipment and real-estate corporation' (where the senior partners will typically own larger shares and the new partners less).

And yes, there are 'eat what you kill' radiology groups. Everyones collections are discounted by a percentage of common overhead and the partners take home their individual share. This can work great, because nobody will look at another partner in a bad way if he chooses to leave early once in a while. But on the other hand, you can end up with 'poaching' of high revenue studies and 'dumping' of low-reimbursement (largely charity) ER and pediatric work (often these groups will end up with mandatory mammo, ER and pediatric coverage to fix this problem. Everyone has to read 30 screening mammos per day or cover the ER board for 6 hours per week)

 

[Rudy Guliani]

I am so sick of stupid mother****ers like hans 19 and matthewtam2002 who need to stick in their 2 cents to increase their post count without actually answering the goddamn ****ing question. That's why this entire board is a ****ing piece of ****...nobody can just answer the ****ing question.

To the OP, one would think that other specialties would also have this kind of problem in their group practices, not just radiology. For example, a cardiology group might have some docs who cherry pick all the caths, and other docs don't get to do as many of the procedures.

 

[Docxter]

I am so sick of stupid mother****ers like hans 19 and matthewtam2002 who need to stick in their 2 cents to increase their post count without actually answering the goddamn ****ing question. That's why this entire board is a ****ing piece of ****...nobody can just answer the ****ing question.

To the OP, one would think that other specialties would also have this kind of problem in their group practices, not just radiology. For example, a cardiology group might have some docs who cherry pick all the caths, and other docs don't get to do as many of the procedures.

Wow! And I think you should be kicked out of the forums for this degree of foul language. Chill man.

 

[(nicedream)]

Are you more interested in
1) radiology
2) how radiology is compensated?

Are you more interested in
1) asking pointless rhetorical questions
2) making this board entirely about "what your profession means to you"

This is a DISCUSSION board.

 

[hans19]

Are you more interested in
1) asking pointless rhetorical questions
2) making this board entirely about "what your profession means to you"

This is a DISCUSSION board.

(Nice dream) Looks like you are more interested in 1)

Rudy, although you didn't answer the OP's question, I appreciate your '2 cents'. Your contribution to this discussion generates extra posts for everybody, including youself! What's that make0-- 51 posts for you? Pat yourself on the back!

 

[(nicedream)]

(Nice dream) Looks like you are more interested in 1)

Irony is the gaiety of reflection and the joy of wisdom.

 

[RADRULES]

It has been my experience that slackers don't last too long in private these days. Private is pretty hardcore. True, some of the older guys are partners and can't be done away with, but thankfully they make themselves useful by reading the GIs, plain films and mammo, leaving high end MR and CT for the younger guys.

If you are real slow or a slacker, word will get around and some how you will be pushed out, unless you offer a special talent that nobody else wants (mammo).

 

[Rudy Guliani]

Wow! And I think you should be kicked out of the forums for this degree of foul language. Chill man.

Oooooh, is that what you think Docxter? I guess I'd better go report myself. And while I'm doing that, I got a foot-long **** for you to suck, why don't you get on that you stupid ****.

 

[LAZYGUY]

what is this, the premed forum?

Certainly we can do better than that....these are your collegues!

Oooooh, is that what you think Docxter? I guess I'd better go report myself. And while I'm doing that, I got a foot-long **** for you to suck, why don't you get on that you stupid ****.

 

[Voxel]

Please refrain from using profanity as it is a violation of the TOS. You risk being banned for life. Thank you.

 

[PublicHealth]

Gee...20 replies and still nothing substantive.

 

[fedor]

Gee...20 replies and still nothing substantive.

f_w's reply was substantive. Big thumbs up to him.

 

[Hoya11]

Oooooh, is that what you think Docxter? I guess I'd better go report myself. And while I'm doing that, I got a foot-long **** for you to suck, why don't you get on that you stupid ****.

i think its funny you bleep it anyway so who cares
dont ban him

 

[fedor]

You have the freedom to make whatever 'jackass' post you please, and I have the freedom to respond.

Why do I care? Because its annoying when people are more interested in how much you make than what your profession means to you.

If that makes me holier-than-thou, thou canst get on thy knees and kiss my feet or STFU.

Got hypocrisy?

http://forums.studentdoctor.net/showpost.php?p=2948874&postcount=9

 

[CCEMTP2DOC]

Got hypocrisy?

http://forums.studentdoctor.net/showpost.php?p=2948874&postcount=9