Get into the office and stay there. Work as bookkeeper, assistant or receptionist; but be a permanent presence in the office.
There are two reasons for you to be present: the money and the honey.
If you aren't there watching the money, it will soon start to disappear. Sooner or later the doctor will find at the end of the month there is no money left for him. No matter how honest the employees seem, they believe that all doctors are rich and they will soon help themselves to the money. Beware.
The honey: that cute young well built little assistant is doctor hunting. It will go like this: One afternoon when everyone else is gone she will plead to the doctor in a very frightened demeanor that she has a lump in her breast. She will quickly strip to the waist and sit on his desk for an examination. He will examine her professionally and reassure her that she is okay. Two weeks later same scenario. This time she gets a little cozy and admits that she loves having him touch her. Soon the two are having regular petting sessions in the office and before long sexual intercourse in the exam room. She may get pregnant on purpose for a big law suite or she may make a play to become the new second wife. If the doctor hits mid-life crisis, wife number one is in deep trouble. She will find herself divorced, 40 years old and with four or five children. Not exactly romance material. Remember the famous words of the last such divorcee: "Oh, my husband would never do that to me!"
Beware!
Sunday, July 26, 2009
Friday, July 24, 2009
The subject for today is the $10,000 arthroscopy of the knee. The principles apply to arthroscopies of the hip, shoulder, elbow and other joints; but the knee is most commonly overcharged.
The problem begins when you or your son or daughter sprains a knee playing sports. The knee is swollen and painful and the patient can't bear weight on the leg.
You consult an orthopedist who gets an x-ray (entirely appropriate) and examines the knee briefly. He then recommends arthroscopy. The patient is admitted to day surgery at the local day surgery center and arthroscopy performed. The doctor comes out after the procedure and says the knee has no major damage and will be okay. Further, no follow-up is needed.
The doctor's bill arrives a few days later and the surgeon's charge is $10,000!!
This is pure extortion. The fee is exorbitant. This examination in the office took fifteen minutes, the arthroscopy took fifteen minutes. But what about overhead: malpractice insurance, office rent, and office staff. The orthopedist does at least 300 cases per year and a generous allowance for overhead would no more than $2000 per case.
So the doctor wants to charge $8000 for thirty minutes professional services. This is simply too much. There is nothing he did or can do that is worth $16,000 per hour.
The solution for you is to find out ahead of time what the doctor plans to charge. If he says he doesn't know his own charge schedule -- he's lying. Go somewhere else. Go to a large well known clinic where the doctors are salaried and not paid a fee per case. Good Luck.
The problem begins when you or your son or daughter sprains a knee playing sports. The knee is swollen and painful and the patient can't bear weight on the leg.
You consult an orthopedist who gets an x-ray (entirely appropriate) and examines the knee briefly. He then recommends arthroscopy. The patient is admitted to day surgery at the local day surgery center and arthroscopy performed. The doctor comes out after the procedure and says the knee has no major damage and will be okay. Further, no follow-up is needed.
The doctor's bill arrives a few days later and the surgeon's charge is $10,000!!
This is pure extortion. The fee is exorbitant. This examination in the office took fifteen minutes, the arthroscopy took fifteen minutes. But what about overhead: malpractice insurance, office rent, and office staff. The orthopedist does at least 300 cases per year and a generous allowance for overhead would no more than $2000 per case.
So the doctor wants to charge $8000 for thirty minutes professional services. This is simply too much. There is nothing he did or can do that is worth $16,000 per hour.
The solution for you is to find out ahead of time what the doctor plans to charge. If he says he doesn't know his own charge schedule -- he's lying. Go somewhere else. Go to a large well known clinic where the doctors are salaried and not paid a fee per case. Good Luck.
Thursday, July 23, 2009
The GP Surgical Assistant
The family doctor general practitioner as a surgical assistant. This is a bad and expensive idea. The situation usually develops when the patient is seen by the GP for a problem that requires surgery; for instance, a 60 year old lady with gallstones and severe pain after meals. An ultrsound study of the gallbladder shows numerous small stones. Her gallbladder tries to contract after meals and a stone obstructs the gallbladder outlet and causes pain. Removal of the gallbladder cures the problem and prevents serious complications like obstruction of the bile ducts.
The GP refers the patient to a general surgeon for gallbladder removal with the agreement that the GP will perform as surgical assistant. He is not required, a nurse can perform as well or better but the GP plans to bill a fee equal to 1/4 the amount the surgeon charges. Further, the GP plans to stay in the operating room the shortest posssible time so he can get back to his office.
Some GP's are good surgical assistants, some are poor; no matter, they aren't needed. This is simply a money maker.
If your GP tells you he needs to help with the operation so he can perform better post-opertive care in years to come, tell him to read the operative note and the pathology report. He simply doesn't need to be scrubbed in at the operation.
The GP refers the patient to a general surgeon for gallbladder removal with the agreement that the GP will perform as surgical assistant. He is not required, a nurse can perform as well or better but the GP plans to bill a fee equal to 1/4 the amount the surgeon charges. Further, the GP plans to stay in the operating room the shortest posssible time so he can get back to his office.
Some GP's are good surgical assistants, some are poor; no matter, they aren't needed. This is simply a money maker.
If your GP tells you he needs to help with the operation so he can perform better post-opertive care in years to come, tell him to read the operative note and the pathology report. He simply doesn't need to be scrubbed in at the operation.
$25,000 Pacemaker for 105 Year Old Lady
I recently heard on the radio a story about a 105 year old lady who needed a pacemaker. The cost of the pacemaker was $25,000!
This is pure exploitation. Several companies make simple fixed rate non-programmable units that are only a few thousand dollars, maybe even a few hundred dollars.
The doctor who recommended the high cost unit probably a financial relationship with the pacemaker company; there is something going on. The doctor may say he has to have a programmable unit, but that is baloney.
When this elderly heart is sick enough for a pacemaker it will probably last only a year at the most. The little lady is going to die soon because the heart is old and sick. The conduction system has gone out. She won't last long. There is no need for a $25,000 pacemaker.
If the doctor will not cooperate call one of the pacemaker companies (Google: "pacemaker manufaturers") and get the model number for their simple non-programmable pacer. Then ask for the names of doctors in your area who use the company's pacemakers.
This is pure exploitation. Several companies make simple fixed rate non-programmable units that are only a few thousand dollars, maybe even a few hundred dollars.
The doctor who recommended the high cost unit probably a financial relationship with the pacemaker company; there is something going on. The doctor may say he has to have a programmable unit, but that is baloney.
When this elderly heart is sick enough for a pacemaker it will probably last only a year at the most. The little lady is going to die soon because the heart is old and sick. The conduction system has gone out. She won't last long. There is no need for a $25,000 pacemaker.
If the doctor will not cooperate call one of the pacemaker companies (Google: "pacemaker manufaturers") and get the model number for their simple non-programmable pacer. Then ask for the names of doctors in your area who use the company's pacemakers.
Subscribe to:
Posts (Atom)