Why does AAMC advocate more residency slots when it hurts physicians?

[Wordead]

That may apply to non-proceduralists but procedural specialties don't want inappropriate referrals. Proceduralists aren't paid for the number of patients they're seeing in office. They're paid largely by getting people to sign up for surgery. If the patients you're referring have no indication for surgery, it generates less revenue for the practice than seeing a patient who does have an appropriate indication for surgery.

I still maintain that medicolegal reasons and fear of "negative" reviews is not an ethical or defensible reason for a frivolous referral. You're on a slippery slope. Would you prescribe antibiotics for a clear case of a viral illness just because the patient is demanding and threatening to post a negative review?

You think surgeons dont get paid to see patients in clinic? I get paid the same if they need surgery or not.

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[aldol16]

You think surgeons dont get paid to see patients in clinic? I get paid the same if they need surgery or not.

I suspect that most of your revenue generation is not from 99213 codes. I bet that most of your revenue generation is from the professional fees you're billing for the procedures you're doing.

 

[collegestud2013]

You think surgeons dont get paid to see patients in clinic? I get paid the same if they need surgery or not.

They definitely make per hour when doing a surgery/procedure than seeing consults or follow-ups, but unfortunately no surgeon will be spending 100% of their time in the OR. They are responsible for all the preop and postop care as well, so a good share of their revenue still comes from E&M. In theory, over-referring could lead to a surgeon seeing more patients for consults that don't end up needing an operation.

 

[VA Hopeful Dr]

They definitely make per hour when doing a surgery/procedure than seeing consults or follow-ups, but unfortunately no surgeon will be spending 100% of their time in the OR. They are responsible for all the preop and postop care as well, so a good share of their revenue still comes from E&M. In theory, over-referring could lead to a surgeon seeing more patients for consults that don't end up needing an operation.

Not always.

 

[Smurfette]

Not always.

True, but it also means that certain procedures are especially undervalued for the time involved.

 

[VA Hopeful Dr]

True, but it also means that certain procedures are especially undervalued for the time involved.

I remember Winged Scapula talking about how little y'all get paid for central lines as a prime example.

 

[Wordead]

I suspect that most of your revenue generation is not from 99213 codes. I bet that most of your revenue generation is from the professional fees you're billing for the procedures you're doing.

Well I code level 4s pretty much universally but otherwise probably 70% of my revenue generation is from clinic. In the end it doesn't help in terms of revenue generation (at this point in time) to see more surgical patients since our bottleneck is pretty much always OR time - I can never get enough but due to staffing issues can't add OR days easily and every other service is also trying to get time.

A single level 4 clinic visit will pay the same as a tonsillectomy. Between the tonsillectomy, turnover, postop, etc I can see 4-6 patients in the same amount of time. So those low reimbursement procedures are not where I make money. If you're talking about generating revenue for the hospital with anesthesia, facility fees, etc then sure. But I dont see a dime from that stuff. If I can do 100% sinus/ears/thyroids and not do any laryngology/tonsils/other low reimbursement procedures, sure maybe it would be higher than clinic but otherwise unless you're not seeing many patients in clinic it would be hard to surpass a full clinic day, at least in ENT.