Reasons for lower Geriatrician salaries?

[ProspectiveKidd]

Does this primarily come down to medicare and that geriatricians are unable to bill for procedures? Or is it because society as a whole just devalues this population group?

Im not in medicine for the money, but I am very interested in geriatrics and palliative care. Just trying to get a grip on why the pay scale works the way it does, and in turn learn some more about the profession.

---

Members don't see this ad.

 

[Cawolf]

I would agree that it has to do with a higher percentage of patients having Medicare as opposed to other insurance.

 

[Mad Jack]

Pretty much your first sentence.You don't do any procedures, and the vast majority of your patient population is on Medicare, leaving you with low reimbursement for your services. It's basically volunteering to work with the absolute lowest reimbursing patient population possible outside of perhaps ID.

 

[ProspectiveKidd]

Pretty much your first sentence.You don't do any procedures, and the vast majority of your patient population is on Medicare, leaving you with low reimbursement for your services. It's basically volunteering to work with the absolute lowest reimbursing patient population possible outside of perhaps ID.

None?? Or is it that you just can't bill for them specifically?

 

[Mad Jack]

None?? Or is it that you just can't bill for them?

I mean, you do procedures, but not anything that reimburses well or is recurring. Might lance a boil here, stitch up a cut there, disimpact an ear or whatever, but it's basically the same stuff you'll do in a PCP office, only on exclusively old people with terrible insurance.

 

[ProspectiveKidd]

I just think it sucks; this population group is devalued already and the reimbursement of care is not helping. This probably leads to decreased time spent with patients among physicians and worse care overall.

 

[allantois]

I just think it sucks; this population group is devalued already and the reimbursement of care is not helping.

Excuse me, if it wasn't for Medicare they would have no coverage whatsoever.

 

[Cytarabine]

Longer visits, family discussions. Doesn't reimburse as well regardless of payer mix

 

[Glandzburg]

The salary of the providers caring for a select population does not reflect that population's value to society. In this case it is a reflection of the payer mix and lack of billable procedures performed. It sucks for students interested in some fields, but that's just how our current reimbursement system works.

 

[The Knife & Gun Club]

Just a passing thought, but I feel like maybe not so much of geriatrics really needs to be done by a doctor. Perhaps the model of a physician supervising several NPs or PAs would work pretty well here.

 

[Annabell Lee]

Just a passing thought, but I feel like maybe not so much of geriatrics really needs to be done by a doctor. Perhaps the model of a physician supervising several NPs or PAs would work pretty well here.

I work in a nursing home, we have a doctor, a PA, and I've heard there is an NP somewhere. The PA does a lot of work and is there more than the doctor. I believe they are all employed by the company which owns the nursing home. This might be another factor. Are they actually billing per patient or getting an hourly rate or (more likely) salary from the facility?

 

[ProspectiveKidd]

Just a passing thought, but I feel like maybe not so much of geriatrics really needs to be done by a doctor. Perhaps the model of a physician supervising several NPs or PAs would work pretty well here.

I work in a nursing home, we have a doctor, a PA, and I've heard there is an NP somewhere. The PA does a lot of work and is there more than the doctor. I believe they are all employed by the company which owns the nursing home. This might be another factor. Are they actually billing per patient or getting an hourly rate or (more likely) salary from the facility?

Same here... two NPs are there every day, but there are always 5-6 doctors that come in. I see at least one or more every day.

There is study going on which is funded by medicare and they pay NP salaries for the nursing home. They are seeing if the presence full time NPs can reduce unnecessary hospitalizations. Still has a few more years to go I believe, I think its a 7 or 8 year study. From what I can see, the NPs are doing a hell of a lot; I wouldn't doubt if this becomes the standard, particularly if this study is fruitful.

 

[ProspectiveKidd]

edit

 

[gwooooooooooooooooooood]

If you want to go into geriatrics and salary is a big concern, keep in mind your salary is still well above the national average, and (outside of manhattan, SF, etc.) your salary will be well above local averages.

You can also do more than geriatrics after you get your fellowship in geriatrics. Many medicine doctors are medical docs with expertise in geriatrics, and boost their incomes that way.

 

[frosted_flake]

As an EMS worker, we dread the presence of the NPs in our local nursing home... Because when they leave, they send 8 or so patients out for everything from 'abnormal labs' which are always abnormal, to 'fall 4 days ago.' Its a clown fest!

 

[Law2Doc]

...keep in mind your salary is still well above the national average, and (outside of manhattan, SF, etc.) your salary will be well above local averages....

This kind of statement is very apples and oranges, and probably shouldn't ever be made in the context of professional careers. The national average isn't an appropriate benchmark. You don't go to four years of professional school and three years of residency to be compared to a "national average". The national average is weighted down by high school grads lucky to earn minimum wage. This figure should never enter the conversation for careers where you are taking out hundreds of thousand dollars in debt and starting down a decade long path of schooling and training. It's not a useful frame of reference -- Apples and oranges -- the kid managing the local Burger King simply isn't a peer or the one you as professional should be comparing yourself to. You can be very poorly paid as a doctor and still bring in more than the "national average" but at the end of the day that shouldn't make you feel any better.

It's kind of like saying your old broken down car isn't so bad compared to a bicycle, ignoring the fact that the appropriate comparison is only other cars. At least you didn't say OP would be living quite well compared to the average worldwide.