“I need to hire another person to help with referrals. We just cannot keep up.”
It was true.
To get a patient an appointment with a specialist requires multiple phone calls and faxes and flat out being pushy. It would be nice to be able to fax over a referral request and information and trust that the specialist offices would contact the patient, making the appropriate arrangements but that is not how it usually works. Not even hardly. More often than not it is more like waging war on that patient’s behalf.
War requires soldiers.
“Ok. You should know that will put you above the recommended full time employee per physician recommendation. Here is how that will affect your salary.” He laid a single sheet of white paper down on the desk and turned it towards me.
There was a jumble of numbers.
Yeah, yeah, yeah….
I scanned down to the important part. There it was in black and white. My income would decrease by almost $40,000 by the time I was through paying for this employee’s salary and benefits.
Still. It was the right thing to do.
Meanwhile, this man sitting before me was paid a salary by corporate (via the money that myself and all of the other practicing physicians and surgeons paid into the system) that approached $120,000. He was 27. He was fresh out of MBA school. The many people above him were making much, much more. This decision would not affect his bottom line.
I felt the anger well up. Jealousy. Frustration. Embarrassment. The realization that they were making money off of me… us. And yet, I do need them. I need legal and malpractice coverage. I need finance and accounting help. I need compliance. I need tech support.
Mind you, this was a few years ago… I am long over the shock.
We talk about how cash strapped physician practices are, how there is so much pressure to see more patients. Rush, rush, rush. Fine. Why? When our healthcare system in the US is so expensive, when vast sums of money are exchanging hands….
Where is it all going?
Why can’t my patient in the hospital have adequate staffing to ensure that he can get the required assistance to get to the bathroom before soiling himself? Take just a few million from the hospital system CEOs $21 million compensation package and hire a few extra staff. Right?
More staff may not be cost effective, though, when you can have a “concierge” come through later after the poop is cleaned up and hand the patient a $25 gift card for the hospital cafeteria as a way of saying “so sorry”. $25 vs a whole emoloyee or two for good patient satisfaction surveys? It is a no brainer.
Whispered behind closed doors: She just has no clue about the economics at play here. We are essential to the practice of medicine. She would have no insurance contracts if it weren’t for us. We do what physicians cannot to make medical practices successful.
Maybe I am ignorant?
If you want to read more about it, check out this recent NY Times article, Medicine’s Top Earners are not the M.D.’s.
Meanwhile, I think I will go get an MBA…