CNNMoney: Doctors going broke

[Blake]

Doctors in America are harboring an embarrassing secret: Many of them are going broke.

This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.

Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.

"A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame.

Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. "And we still barely made payroll last paycheck," he said. "Many of us are also skimping on our own pay."

Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. "Our total revenue was down about 9% last year compared to 2010," he said.

"These cuts have destabilized private cardiology practices," he said. "A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well."

Pentz is thinking about an out. "If this continues, I might seriously consider leaving medicine," he said. "I can't keep working this way."

Also on his mind, the impending 27.4% Medicare pay cut for doctors. "If that goes through, it will put us under," he said...............

http://finance.yahoo.com/news/small-business-doctors-going-broke-101200127.html

[ElNono]

Looks like it's time to adapt...

[ploto]

I am willing to bet that many of these doctors in financial trouble are so because they invested in real estate.

They also are some of the dumbest men on earth when it comes to money.

[Blake]

They also are some of the dumbest men on earth when it comes to money.

Yeah, I'm thinking very few take business courses in college

[Agloco]

Cynicism from the peanut gallery?

Looks like some will adapt by getting out of medicine.......and go into finance no doubt. :lol

[CosmicCowboy]

Cynicism from the peanut gallery?

Looks like some will adapt by getting out of medicine.......and go into finance no doubt. :lol

No shit!...lol@ peanut gallery

[ChumpDumper]

I am willing to bet that many of these doctors in financial trouble are so because they invested in real estate.

They also are some of the dumbest men on earth when it comes to money.As the son and brother of doctors, I have to agree.

[boutons_deux]

denigrating doctors as shitty business people may be somewhat justified, but doctors are in an untenable swamp of overheads, so much so that they are forced out of primary care (leaving a huge deficit in primary care docs) into better paying specialties, and from working their dream of the autonomous, self-employed operator into working in associations, clinics, hospitals where overheads are shared.

The overheads are horrendous:

http://www.medicalpmrg.com/resources/overhead-cost-analysis.html

Can't find it now, but a Canadian doc spends about $25K interfacing with insurance, while a US doc spends $75k+.

And like people suckered into legal education, doctors exit residency with many $10Ks in debt, even $100K+.

etc, etc, etc.

USA #1!!, Best Medical System In The World? Just another fucking myth.

$100Bs wasted in friction and overheads rather than on delivering medical care, frustrating and impoverishing the docs and the patients, many of whom are denied care due to the greedy docs and the greedy insurance companies charging exorbitant prices, a problem health reform has not addressed.

A hard-core public insurance option, Medicare for all paid by levies on (all) income, is the best solution, as other countries have demonstrated for decades.

Another solution would be govt-subsidized medical education in return for 20 years service as a govt-employed, salaried doctor (no fee-for-service scam), and a fully computerized, heavily standardized govt medical records/claims system.

[DUNCANownsKOBE]

They also are some of the dumbest men on earth when it comes to money.
This. They make gross amounts of money (more than most people who do take business classes) but spend it all immediately.

[boutons_deux]

Expenses: Rising costs hit all physicians

http://medicaleconomics.modernmedicine.com/memag/content/printContentPopup.jsp?id=476095

Not that I have any sympathy for doctors (or lawyers), but they are hardly in full control of their financial picture.

[boutons_deux]

Study finds universal health care would cost less than bailouts

http://rawstory.com/news/2008/Study_finds_universal_health_care_would_0301.html

but the UCA will never permit it, will spend $100Ms to maintain their profits, with dirty tricks like this:

Health insurers ran secret campaign to trash Michael Moore’s ‘Sicko’

http://www.rawstory.com/rs/2010/11/17/health-insurers-ran-secret-campaign-trash-michael-moores-sicko/

[TDMVPDPOY]

a private practice is like a business, in a view to make profit....

so why are they complaining?

[boutons_deux]

This. They make gross amounts of money (more than most people who do take business classes) but spend it all immediately.

bullshit

[CosmicCowboy]

a private practice is like a business, in a view to make profit....

so why are they complaining?

Because the sickest requiring the most care are usually medicare/medicaid patients which pays the least. Like going into a restaurant and ordering a cheeseburger that everyone else pays $6 for and telling the restaurant...nope...you still have to serve me but I'm only gonna pay you $2.50.

[SnakeBoy]

More and more docs are going to concierge medicine. My wife knows several who already have made the switch and she has looked into it herself although she doesn't want to go this route unless she has no choice.


Concierge medicine grows despite recession
Patients pay extra for quicker access and personalized care.
December 19, 2011|Lois K. Solomon, Sun Sentinel

The recession has not stopped some South Floridians who value personalized medical care from paying $1,500 a year or more to guarantee a same-day appointment with their favorite doctor.

Frustrated with long office waits and feeling rushed during examinations, many pople have switched to concierge practices that charge an annual fee for what they consider top-notch care, including minimum 30-minute physician visits and access to the doctor's cellphone number.

Although some have criticized these boutique practices as medicine for the elite, others say they are the logical result of the deterioration of U.S. health care, with doctors forced to see many patients and perform lots of procedures to stay solvent.

So, patients pay the hefty fees to get same-day appointments without long waits, thorough physical exams, 24-hour availability and doctors who are less stressed. They still need health insurance for hospital stays and specialists.

Many see South Florida as the nation's concierge medicine capital. MDVIP, one of the country's largest concierge physician networks, reports that 37 of its 55 member physicians in the state practice in South Florida, its largest geographic concentration. Across the country, about 3,500 doctors have joined boutique practices, up from about 700 five years ago, according to the American Academy of Private Physicians.
Advertisement"In an ideal world, I would offer this kind of service and charge no fee," said Dr. Lanalee Araba Sam, a Fort Lauderdale obstetrician who charges $7,500 for prenatal visits and childbirth, with the promise of handling only four deliveries a month, compared with 40 at many practices.

She offers fetal ultrasound at each visit, three massages, and to stay with each patient through her labor and delivery, no matter the length. "It's my fee to maintain a viable practice, to give better care to fewer patients."

Since most people cannot afford the fees, concierge medicine caters to "an upper-class niche market," said Arthur Caplan, a bioethicist at the University of Pennsylvania. Caplan said he sympathizes with overworked doctors, but sees several problems with concierge care.

Most concierge physicians are primary-care providers, for whom there is a desperate need in the United States. A government report says 65 million Americans live in areas designated as having a shortage of primary-care physicians. The concierge system takes these doctors out of general circulation.

In addition, he said, there's no guarantee a patient gets improved care. Patients should not have to pay more to get a prompt call back from a doctor, he said.

"It's a tragic indictment of what we've let our health care system deteriorate into," he said. "We only have ourselves to blame for its appearance, because we haven't fixed the climate that's turned medicine into a fast-food operation."

MDVIP, based in Boca Raton with 500 doctors across the country, reports a 92 percent retention rate during the recession, said Mark Murrison, president for marketing and innovation. Fees are $1,500 a year, and each doctor is limited to 600 patients, compared to more than 2,000 in some practices, Murrison said.

Dr. Robert Mellman and his wife, Dr. Cheryl Moss- Mellman, switched to a concierge practice in 2007 and charge $1,800 per patient. Mellman said their patient load has remained stable during the recession's ups and downs, and they are thrilled to be able to spend as much as an hour with a patient if needed. They used to see 30-40 patients a day; now they see 10-15, he said. "I realized it would be impossible to do high volume and quality at the same time," Mellman said. "It was emotionally and physically exhausting."

The promise of personalizd care spurred Richard Pomerantz, 85, of Boca Raton, to stay with Mellman when the practice switched over four years ago. Pomerantz said he has had melanoma, lymphoma and bladder cancer. Mellman examined Pomerantz at his house recently and told him not to take an airplane trip. Mellman called him four times the next day to see how he felt, Pomerantz said.

Mellman "had too many patients before and couldn't give us the time he wanted to," Pomerantz said. "Since he switched, the service has been exceptional, and worth every cent."

[boutons_deux]

"Pomerantz said he has had melanoma, lymphoma and bladder cancer."

aka, Dead Man Walking, but Mellman can surely suck a couple $100K out of Pomerantz, which is what The Cancer Industry is all about.