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Decreasing Reimbursements = Dissatisfied Docs + More Burnout

Dana Corriel, MD comments on the continued devaluation of the educated individuals within the healthcare system, and its dangerous repercussions.

April 3, 2024

When Daniel Paull, MD explained in an article titled HOW MUCH DOES A JOINT SURGEON GET PAID FOR EACH JOINT THEY REPLACE? THE ANSWER MAY SURPRISE YOU! that joint surgeons get paid much less than many would think, it came as no surprise.

When you really break things down in healthcare (no pun intended, as the point of this article is built around undergoing a joint replacement), you start realizing that money doesn’t necessarily flow in the direction you think that it does.

Reimbursements have gradually shrunk, over the years, as the system continues devaluing the educated individuals within it.

Robert Kornfeld, DPM, a podiatrist, agrees. When I shared my thoughts with him and my other followers online, he reported, first hand, a decrease in his own surgical procedure reimbursements .

“My first bunionectomy (non-implant procedure) performed in 1982 paid me $3,200,” he said. “In today’s dollars, that computes to about $10,000.”

“However,” he continued, “Insurance now pays in the neighborhood of $750 in 2024. That fee includes 90 days of aftercare. Based on inflation, this is a 92.5% reduction!!! Is it any wonder that doctors are suffering financially with very high expenses and very low reimbursements? There is no reason that makes sense to me to continue to accept insurance reimbursements.

 

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As a member of the general public, you may not think this affects you. But it will.

The more you take away from the healthcare professionals who actually run the health visit (not the ones who run the systems, but the actual visits), the more you will continue seeing increasing rates of burnout and attrition from our field.

As an instructor in a school of nursing, Horace T. Bone PhD was constantly approached by administrators who wanted to ‘help’ him teach better.

“How [they could help] . . . I couldn’t comprehend,” he shared. “I guess they wanted to feel useful, but they were only impediments with whom I had to deal.”

The layers that have gotten added in between patient and caretaker, the physician, not only build impediments to good care, but are done opaquely. because of this, it isn’t always clear where the money even goes, most of the time.

Nicholas Kaknes, MD, a hospitalist at the VA said that “Medicare spent an average of $15,727 per beneficiary in 2022, an average 4.6% increase per year since 2000. Reimbursement rates aren’t the problem, it’s where those dollars are going that is the problem.”

It sure isn’t going to the doctors who actually perform the procedures.

Can you imagine if this happened in other industries?

 

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Imagine, for example, if you were a hairdresser and that each time you gave someone a haircut, the money flowed through various separate hands, who each took a cut.

Imagine that, over time, that amount got less and less, and you weren’t even sure anymore who had their hands in the mix.

People kept booking appointments, or walking through that door, and you kept working hard giving great haircuts. You just continued earning less.

Would you be happy?

Would you stay?

“Hey, but don’t worry,” said Andrew Smith, MD, board certified emergency room physician, when I shared my thoughts online.

“The C-Suite folks are getting paid well!!!!”

 

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What we’re going to start seeing because of this, and other issues factoring into the dissatisfaction of doctors today, is less of the younger generation pursuing medicine.

There will surely be a trickle-down effect. Plus, word is getting out.

It’s not just because of the lowered compensation issue, as I mentioned. It’s because of overall declining control and respect.

The entire field is caving in, from all sides.

“Not only will we see far less college students applying to medical school,” Dr. Kornfeld said to this, “But licensed doctors are quitting medicine en masse.”

Here’s my take: Value the healthcare expert. Bring back autonomy. It’s really quite straightforward.

Dana Corriel, MD

Dana Corriel, MD

“I haven’t LEFT medicine, I’m simply taking time to tackle its issues from a different angle. I’m stepping out of the traditional medicine box.”

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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One Response

  1. Physicians are a major part of the problem by never saying “no!” to insurance companies and administration. AMA is toothless to the point of supporting physicians.

    Maybe teach business classes in medical school and how to read a comtract…oh, no…medical schools are part of the system holding physicians down.

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