Thursday, August 16, 2007

Medical Procedures-show me the money

Several times a week I get mailers or ads offering courses in medical procedures. This one reads: "Why learn procedures? You are working harder and making less. (They got that one right). Procedures will help you increase revenue and profits without a large investment or extensive training. You do most of the work, others get paid more than you" (Bingo, right again). "Stop turning revenue away by sending your patients to specialists".

So what are these easy, fun and inexpensive procedures that will "put you on the path to a better practice"? The list is extensive: peels, microdermabrasion, hair removal, botox. If that is not appealing, I could learn "anti-aging medicine, advanced colonoscopy or carotid ultrasound". Lots of patients have varicose veins. For $750.00 and two days out of my life I can learn sclerotherapy.
My favorite is the "No-scalpel vasectomy".

The sad thing about these mailers is that the statements about increasing revenue by doing very little is real. Insurance and Medicare payments are disproportionately high for the amount of time and skill involved for most procedures. Or perhaps a better way of saying it is that physicians who spend time with patients, listening, diagnosing, interpreting tests and communicating are financially penalized. A scope or a scalpel will be far higher valued, even though the time spent (and brainpower) is far less.

Patients will pay large fees out of pocket for cosmetic procedures or anti-aging vitamins. In our capitalistic society, it is clear what is valued.

As long as primary care and "cognitive" specialists are reimbursed so poorly, these ads will have great appeal to many physicians. With the decline in medical students choosing primary care, pretty soon there will be no-one to market to.


Rich said...

True a lot of patients walk out of a visit frustrated that the doctor only spent 15 minutes with them. It's not the docs fault as medical centers have to become more competitive and insurance companies dictate time and policy.

Anonymous said...

Yes! As a doctor who spends time listening, diagnosing and treating patients, I work long days, take night and weekend call and manage the overall care for thousands of patients. My husband is an anesthesiologist and he works a set shift, has no call and is paid almost 4 times my income. Thank heavens I am married to a doctor whose work is valued.