Working in healthcare economics as a physician

[deleted1138671]

I’ve had something on my mind for a few days. I’m premed and applied for MD/PhD programs in bioengineering (medical imaging) research.

But something made me rethink my decision to pursue an MD/PhD: a few days ago I got the bill for my Dexa bone density test (I’ve always had irregular menses - amenorrhea - and low estrogen levels, so they were checking my bone density; but that’s irrelevant to this story). The bill for the scan, a glorified x-ray, was $700.

It literally took less than 10 minutes to run. And the report was given in terms of standard deviations from normal, not even a true summary from a radiologist.

My mom was kinda pissed at the bill. And frankly, I was pissed too.

Can I work on improving healthcare affordability and economics in general as a doctor? Or is that not something physician-scientists usually do?

If developing affordable healthcare technology is something I wanna focus on, is medicine still for me? Or should I pivot to something like governmental policy work or econometrics research?

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[Princeton Medical Student]

One of the best ways to fix healthcare at it’s current state is through research. With sufficient effort and technology you could invent a time machine to go back in time and fix healthcare.

 

[Med Ed]

I’ve had something on my mind for a few days. I’m premed and applied for MD/PhD programs in bioengineering (medical imaging) research.

But something made me rethink my decision to pursue an MD/PhD: a few days ago I got the bill for my Dexa bone density test (I’ve always had irregular menses and low estrogen levels, so they were checking my bone density; but that’s irrelevant to this story). The bill for the scan, a glorified x-ray, was $700.

It literally took less than 10 minutes to run. And the report was given in terms of standard deviations from normal, not even a true summary from a radiologist.

My mom was kinda pissed at the bill. And frankly, I was pissed too.

Can I work on improving healthcare affordability and economics in general as a doctor? Or is that not something physician-scientists usually do?

If developing affordable healthcare technology is something I wanna focus on, is medicine still for me? Or should I pivot to something like governmental policy work or econometrics research?

The $700 bill is an artifact of a payment practice that was pioneered by Medicare long ago. They essentially said they would pay a set amount or a percentage of the billed amount, whichever was lower. If you wanted to get paid the maximum allowable then you had to over-bill.

Medicare also said if you billed someone else for less for the same service, they would determine their reimbursement based on that smaller charge. So you had to bill everyone the same as Medicare (or higher).

Medicare's desire to control spending is rational, but the unintended effects on billing practices have been unfortunate (to say the least).

Options for addressing this include the following:
1. Get a MD/MPH and work inside the federal or state government on health policy
2. Get a MD/MBA and work inside a major health system or health insurer
3. Become an individual advocate/activist (like a member of the PHNP)
4. Do what a sane person would, get the MD, move to Canada, and never see another healthcare bill again

 

[Princeton Medical Student]

The $700 bill is an artifact of a payment practice that was pioneered by Medicare long ago. They essentially said they would pay a set amount or a percentage of the billed amount, whichever was lower. If you wanted to get paid the maximum allowable then you had to over-bill.

Medicare also said if you billed someone else for less for the same service, they would determine their reimbursement based on that smaller charge. So you had to bill everyone the same as Medicare (or higher).

Medicare's desire to control spending is rational, but the unintended effects on billing practices have been unfortunate (to say the least).

Options for addressing this include the following:
1. Get a MD/MPH and work inside the federal or state government on health policy
2. Get a MD/MBA and work inside a major health system or health insurer
3. Become an individual advocate/activist (like a member of the PHNP)
4. Do what a sane person would, get the MD, move to Canada, and never see another healthcare bill again

The unfortunate part of #4 is having to live in Canada.

 

[deleted1138671]

The unfortunate part of #4 is having to live in Canada.

Yea I don’t do cold weather