what to do if the law is not pushing through to pay PCP more?

[Nutoamerica]

Just wondering if real world docs can give some ideas on how they do in their practices, since the laws of compensating primary care docs might never get passed...
I mean people are talking about it, but the initial studies were in the 1980s by harvard, and it has been 30 years since...and we are still "talking" about the possibilities...

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[radslooking]

Just wondering if real world docs can give some ideas on how they do in their practices, since the laws of compensating primary care docs might never get passed...
I mean people are talking about it, but the initial studies were in the 1980s by harvard, and it has been 30 years since...and we are still "talking" about the possibilities...

Yep, and they'll likely keep talking about it. I don't think an economy in a slump, or any economy, is going to feel bad for people making 150,000 a year. If there is an increase in pay, it will be minor I suspect. Yes, I think the other specialties will take a hit, probably more so, but I have a hard time believing salaries will ever be equitable b/w certain specialists and the generalists.

Also, they will keep getting foreign grads/NP's/PA's to replace what they are losing in primary care. It matters not that this may cost them more through increased costs through supervision or increased referrals. I have nothing against NP's and PA's. Im just saying the gov't has not shown it values primary care. They keep saying they feel bad for them, but they don't do anything about it. Who's to say you can't have a ton of specialists caring for a patient with an NP as the outpatient quarterback? It's happening now. This isn't paranoia. No IM doc should be afraid for his job in any fashion. But if the country needs to, they'll find warm bodies to pick up the slack.

Your options? Find some niche of primary care that will pay more. Boutique medicine, moonlight, pick up some new procedures, cosmetics, scopes, sleep medicine. If you are interested, you could own a practice. You can combat poor reimbursement by stop adding Medicare and Medicaid patients. Sounds terrible but many docs are doing it now b/c it doesnt cover costs much of the time.

You can subspecialize of course. Get an MBA and go into business. Get in bed with pharma, do speaking engagements. Or change fields/specialty. As you can see, the list of things you can do runs from reasonable to slightly shady. There are lots of options, but certainly no slam dunk ones. It depends on which options are available and that you will find satisfactory.

 

[Nutoamerica]

speaking of the alternatives, how do you learn all the procedures, I mean where do you find out the informations?
Is there any site for PCPs that are formed geared towards helping PCPs?

 

[Good Solutions]

The problem with primary care is not primary care itself. The problem is the government and insurance companies strangling it from how much they pay and for what they pay for.

The solution is simple. Opt out. Don't take insurance. Don't participate in medicare. Take cash only. Encourage Health savings accounts and high deductible insurance. Or function almost like an urgent care center with a well posted fee schedule.

Retainer medicine is another fine example of how to do well for yourself and your patients. (D)NPs will never be a concern. Eventually the public will learn that they are getting a better bang for their buck with a physician. Once you eliminate the chains of an insurance company you are free again to practice medicine as it should be.

Do not expect the government to do anything. They are the problem and will offer no solutions. Be your own change.

 

[Nutoamerica]

what is retainer medicine?

 

[Good Solutions]

Retainer medicine is where you charge a single annual fee to cover a patient for a year and usually abstain from taking insurance. Some docs do this and only offer outpatient services, some include inpatient management at the hospitals they have privileges at. Other common attributes include 24/7 access, emailing, home visits if warranted, executive physicals, etc. Check out this organization www.simpd.org/ and look at the websites of some of those in practice. You'll get a better grasp of what a retainer practice is.

It is a way for patients to show their commitment to a single physician (as opposed to providers) and their own health. It is also a way for you to show your commitment to practicing medicine the way it ought to be. WIN=WIN

 

[Nutoamerica]

thanks a lot Good Solutions!

 

[DrJosephKim]

Start moonlighting or get involved in some full-time or part-time non-clinical ventures.