I want to earn $910 per hour

It boggles the mind that some people think the cost of healthcare will go down if all doctors become hospital employees.  When a private practice doctor can make a profit by seeing patients for $200, but the fee for the exact same 25 minute appointment becomes $455 when the doctor is employed by a hospital, something is dreadfully wrong.

How can charging more than double be construed as reducing costs?

To me, it seems that patients could put an end to such nonsense by refusing to see a doctor employed by any hospital using such tactics.  Unfortunately, it doesn’t work that way.  Since the insurance reform law passed, it’s getting harder and harder to find doctors in private practice.

For my daughter, it’s impossible.  According to the ACR, there are only five practicing pediatric rheumatologists in my state.  All of them are at Children’s.  If it were me, I’d look for a different doctor – one not affiliated with a hospital extorting facilities fees.  I can’t take my daughter elsewhere, though; there is nowhere else.  We’re stuck.

We recently discovered something that sheds a little light on the situation.  The hospital is requiring doctors to do lots more computer work.  An oddly reasonable administrative ruling has lightened doctors’ patient load to give them time to do that paper computer work.  The problem that the hospital ran into is that if doctors see fewer patients, they’ll earn less money and that puts a huge crimp in the cash flow.  Now I understand the reasoning behind the facilities fee.  Instead of seeing two patients to earn $400, they’ll just see one patient and charge $455.  Half the work, but even more income.

There’s a flaw in that solution.  Tacking on a facilities fee does not mean that the hospital will get more money.  It means that people like me, who would never have dreamed of asking for financial assistance in the past, are now doing it.

Welcome to unintended consequences.

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2 thoughts on “I want to earn $910 per hour

  1. I wish someone would come up with a internet search site whereby a patient could put in certain criteria they are looking for in a doctor (including their cost for services) and get a list of doctors. One would think that having a multitude of doctors using the same facilities would reduce the cost to practice. This defies the logic of business costing. I suspect that the hospital is doing other things that are running up their costs and therefore they are having to milk customers that can pay. Perhaps they are seeing patients without insurance, offering a reduced fee schedule, doing research…my list of possible reasons could go on for hours. Something is wrong here and I would love to see you contact the local paper covering your area and ask them to do an article on this. Now that would get the hospitals attention :-)

    • Children’s is associated with a medical school. Everyone referred there is seen, regardless of whether they have insurance. They offer financial assistance to those who jump through the hoops in order to prove they qualify. The doctors are doing research – my daughter’s rheumatologist has very limited clinic hours because most of her time is spent on research.

      It’s astonishing that they can get away with this when they already charge more for stuff. PT there is twice what anyone else charges. Labs cost twice as much there, too. They’re making way more money than anyone else for the same stuff. They shouldn’t need even more.

      One other parent of a patient that I talked with shrugged her shoulders and said that it’s wrong but doesn’t matter to her. Since they get financial assistance, it won’t affect their family.

      I think I will contact the news agencies and see if media pressure might make a difference. Thanks for the idea.

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