Tuesday, October 11, 2011

Doctors Charging Add On Fees

 My telecom bill is pretty high when you take the basic rate and then add on "additional bundled services ($4.99)", "Internet Services ($7.00)", "Additional Voice Service ($25.72)", Taxes, surcharges and fees ($10.47), "911 fee ($.24)" and "other charges and credits ($2.99).  One way doctors could deal with their declining incomes (down 7%-25% adjusted for inflation depending upon the specialty) is to mimic the phone company.  Just add additional fees and taxes to their charges.

How about:
CLIA lab compliance fee
Electronic medical record maintenance fee
business tax fee
Medical license renewal fee
DEA fee
State mandated pain management course fee
State mandated end of life course fee
Hospital Med Staff application fee
Continuing Medical Education fee

Get the point?  The cost of doing business keeps escalating as does the number of mandated regulations.  Other businesses can adjust by raising prices or charging add on fees.   Physicians cannot. 

We already know health care costs too darn much.  I wish the rest of the "free market" would cooperate by lowering my cost of doing business.


Have Myelin? said...

I really don't know how you guys can deal with patients. I'm on Medicaid and I HATE it. No...I despise it. Wait...is there a stronger word for hate/despise?

It took me five months to schedule my "emergency colonoscopy" (Medicaid works very slooooowwww, you knoooowwwww) and the good Doc (he's really good) doesn't get paid crap.

I feel sorry for both the Doctors and the patients.

Have Myelin? said...

Oh, I meant to add - but I don't feel sorry for the telecom company, only the consumers. =)

Liz said...

amen, toni!


Toni Brayer, MD said...

Have Myelin: I share your concern about Medicaid and have wondered how patients can tolerate it. In California it is MediCal and the payment is #49 out of all 50 states. (States decide what to pay with Fed funds). Needless to say, this creates severe barriers to specialty care for patients as doctors are doing it almost as pure charity. The Feds reimburse primary care clinics better so patients can get "clinic" care but this often involves long waits and bureaucracy.

There is a lot of waste in the system too and we know about fraud and abuse. Medicaid needs to be revamped completely and combined with Medicare to provide better reimbursement and more streamlined care for all patients.

Liz: thanks

Michael Kirsch, M.D. said...

Great analogy with the phone and cable bills! For physicians, rising overhead with declining reimbursments is a slow strangle on us. Do we want all physicians to be employees? That's where we're headed. Great post, Toni.

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