I once went out for a lunch buffet with an Indian doctor in Tennessee. I went to discuss some business related to practice management software. As we began to have our lunch, an young intern of his joined us. It was a big buffet. So, we had time to talk.
We discussed his practice, about ICD-9 to ICD-10 transition and his general state of affairs. He had been in business for more than a decade. So, he was quite well set. Coming from India, he talked about how he came to pursue this line of occupation rather than the Engineering line. It was not surprising considering that most of the Indians growing in the 80s and 90s mostly had the doctor (MBBS) or engineer (BTech) educations to choose from.
However, as we began to talk about the money part of his business, I sensed that things were not going that well as he would have wanted or as much as he had expected when he chose this profession. It was not because he was losing customers or that there was competition. He talked about how the government was making it hard for him to get paid. You see in the US, the health care insurance companies get into the act once a patient visits a doctor. They go through the due diligence procedures (Coding, billing, claims and whole9 yards) before the doctors and hospitals would get paid. The doctor talked about how delayed payments were upsetting his small practice. He grumbled about how it was no longer lucrative to be in this line of occupation. What’s more, he wouldn’t encourage his own children to purse it. I was surprised that he was that frank about it in front of his intern.
I think the hard times were speaking, but what really amazed me was what the doctor did next at the lunch table. As the waiter placed one more plate of the Indian Naan on the table, the doctor quickly covered it in the paper napkin and swiftly / secretly pushed it in his suitcase.
It is not about being lucrative, it is about sustainability and stability. The business model is changing from FFS to QUALY, using unproven metrics to measure performance and outcomes. Population management does not always translate to the individual patient sitting in front of the provider. It is all about regulating doctors, decreasing utilization and taking the health care dollars for Defense, Education,
Profits In Health Insurance Under Obamacare
Furthermore, our societies, such the AMA have abandoned us. I do not want those organizations speaking for me or you.
They 'negotiate' to maintain some bizarre mindset that patients and providers are in control. Ask a patient if they are in control ?
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