S/o What the f do you all want from doctors?

[Anonymous]

This isn’t controlled by physicians but I’d like a complete overhaul of the US healthcare system.

A lot of the complaints on here are driven by outside forces, not doctors themselves.

Specific to doctors…be kind, listen, and don’t blow off questions/concerns. It’s hard for patients to advocate for themselves with limited medical knowledge. We may know something is wrong but aren’t sure how to approach it. I had an issue that went for years until a doctor finally took a minute to listen and help figure it out.

And, if you own your own practice, hire kind, competent staff. 75% of my unpleasant medical experiences are with rude and/or incompetent staff members.

[Anonymous]

Anonymous wrote:Everyone is mad at doctors. We should be mad at insurance companies and health systems. We should be mad at the broken free market system and republicans in general.

EMRs, while good in theory and intention, were a disaster to roll out. I’m curious how much time and money is spent implementing, maintaining and using these systems instead of focusing on the patient - a recurring complaint on this thread.

Medicine has become like everything else. Ruined by private equity and other bored, rich AHs who are looking for a new “tech disruption”

Exactly.

[Anonymous]

Anonymous wrote:I don’t care what they make. Raise it, lower it, whatever.

I want them to prioritize me as the patient over interacting with the EMR, not to be supercilious AHs, and to answer calls/emails with correct information—not patronizing gatekeeping—in fewer than 72 hours.

I would appreciate it if fewer PCPs punted every single illness involving an identifiable body system to a specialist, but this is lower-level.

If they are going to do this, however, I would like them to actually coordinate care.

Here here!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t care what they make. Raise it, lower it, whatever.

I want them to prioritize me as the patient over interacting with the EMR, not to be supercilious AHs, and to answer calls/emails with correct information—not patronizing gatekeeping—in fewer than 72 hours.

I would appreciate it if fewer PCPs punted every single illness involving an identifiable body system to a specialist, but this is lower-level.

If they are going to do this, however, I would like them to actually coordinate care.

Here here!

Of course that was autocorrected

Hear hear!

[Anonymous]

I've seen probably just over 10 specialists in 3 years all of whom had zero desire to help, no thoughts or additional tests to run, and agreed that I was hopeless. Like I literally don't know what they get paid for.

I had to pay out if pocket for a specialist that finally ran just over 60 tests and got answers. Which then the other specialists were like, oh that's interesting, but I still decline to treat you.

I can't express how frustrating it is.

[Anonymous]

Anonymous wrote:21:55, I forgot two more:

I do to want to have pay to park for the privilege of seeing you

I do not want to wait 30 minutes (or more) in your waiting room and another 30 minutes (or more) in the exam room before I am graced with your presence for less than 10 minutes, and then I have to pay even more for parking, for the time I spent waiting for you

You’re going to have to pay for concierge service to get all of this. It’s readily available to you. But…I’m guessing you don’t want to pay.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:Hit reply too fast. Do you see how this makes zero sense? You want them to know better than you but you don’t want to do what they tell you to do.

Also if they take all those phone calls they’ll never have time to actually see patients in person and also they won’t get paid. Sucks but true. Your quick phone call, multiplied by 15, plus the documentation required for it, would take up hours.

There's A LOT of real estate between "makes $50k a year" and "makes $600k a year". Doctors could stop over-scheduling, spend more time with patients, take phone calls, work on bedside manner and still make what any American would consider a lavish sum. Nobody is asking them to impoverish themselves, just maybe make a couple thou less a day.

Doctors have zero control over their own schedules. Unless they own their own practice, in which case they are struggling to make ends meet thanks to the insurance industry paying Pennies on the dollar.

It looks a lot more than pennies on the dollar when I get my statements. They get hundreds for a few minutes of face time.

What percentage of what is billed do you think goes just to pay overhead to run the clinic, straight off the top, not even including malpractice insurance, maintaining licensure, etc. -- just the lights on, employees paid, and utilities?

This is true of most businesses with rent, salaries, insurance, material and utility costs. The patient is not paying pennies though. They are paying hundreds and thousands of dollars a year.

Right. So what percentage do you think thatis, for a medical practice?

How can I tell? Are you in Manhatten or Front Royal, which affects rent and salaries. What kind of doctor are you - OB-Gyn or dermatologist or PCP, which will impact insurance premiums. Are you a concierge doctor or part of a hospital system? How many support staff do you employ? How long do you spend with each patient?

I don't know the answer to these operating cost questions for my tree service or local supermarket either. Why don't you provide these figures to us?

So you're judging the cost and assigning salary, without any sense of what the average overhead is for a basic medical practice? Okay.

Sure, if you want to know, I'll pull it for you. I'm still interested in what your guess would be. I think it would be informative. FYI, it's different for medicine than most small businesses, for various reasons of specific responsibilities, liabilities, and constraints.

I'm interested if you diagnose your patients without doing any tests or asking the patient any questions. Yet you want to DCUM users to guess overheads without providing any data about your practice's income and costs. Do you diagnose on averages or is each patient different?

[Anonymous]

Anonymous wrote:

Anonymous wrote:21:55, I forgot two more:

I do to want to have pay to park for the privilege of seeing you

I do not want to wait 30 minutes (or more) in your waiting room and another 30 minutes (or more) in the exam room before I am graced with your presence for less than 10 minutes, and then I have to pay even more for parking, for the time I spent waiting for you

You’re going to have to pay for concierge service to get all of this. It’s readily available to you. But…I’m guessing you don’t want to pay.

I'm not paying for concierge services when frankly my PCP is a minor part in my overall health management. The specialists who keep me going don't charge concierge fees.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hit reply too fast. Do you see how this makes zero sense? You want them to know better than you but you don’t want to do what they tell you to do.

Also if they take all those phone calls they’ll never have time to actually see patients in person and also they won’t get paid. Sucks but true. Your quick phone call, multiplied by 15, plus the documentation required for it, would take up hours.

There's A LOT of real estate between "makes $50k a year" and "makes $600k a year". Doctors could stop over-scheduling, spend more time with patients, take phone calls, work on bedside manner and still make what any American would consider a lavish sum. Nobody is asking them to impoverish themselves, just maybe make a couple thou less a day.

Doctors have zero control over their own schedules. Unless they own their own practice, in which case they are struggling to make ends meet thanks to the insurance industry paying Pennies on the dollar.

It looks a lot more than pennies on the dollar when I get my statements. They get hundreds for a few minutes of face time.

What percentage of what is billed do you think goes just to pay overhead to run the clinic, straight off the top, not even including malpractice insurance, maintaining licensure, etc. -- just the lights on, employees paid, and utilities?

This is true of most businesses with rent, salaries, insurance, material and utility costs. The patient is not paying pennies though. They are paying hundreds and thousands of dollars a year.

Right. So what percentage do you think thatis, for a medical practice?

How can I tell? Are you in Manhatten or Front Royal, which affects rent and salaries. What kind of doctor are you - OB-Gyn or dermatologist or PCP, which will impact insurance premiums. Are you a concierge doctor or part of a hospital system? How many support staff do you employ? How long do you spend with each patient?

I don't know the answer to these operating cost questions for my tree service or local supermarket either. Why don't you provide these figures to us?

So you're judging the cost and assigning salary, without any sense of what the average overhead is for a basic medical practice? Okay.

Sure, if you want to know, I'll pull it for you. I'm still interested in what your guess would be. I think it would be informative. FYI, it's different for medicine than most small businesses, for various reasons of specific responsibilities, liabilities, and constraints.

I'm interested if you diagnose your patients without doing any tests or asking the patient any questions. Yet you want to DCUM users to guess overheads without providing any data about your practice's income and costs. Do you diagnose on averages or is each patient different?

No, it's just a simple question. The average doesn't vary as much as you seem to think, and yet the complaints here are not about single, specific practices -- for the most part, they are about doctors in general.

It's interesting, that's all. I wonder if anyone would have gone with 65-70%?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:21:55, I forgot two more:

I do to want to have pay to park for the privilege of seeing you

I do not want to wait 30 minutes (or more) in your waiting room and another 30 minutes (or more) in the exam room before I am graced with your presence for less than 10 minutes, and then I have to pay even more for parking, for the time I spent waiting for you

You’re going to have to pay for concierge service to get all of this. It’s readily available to you. But…I’m guessing you don’t want to pay.

I'm not paying for concierge services when frankly my PCP is a minor part in my overall health management. The specialists who keep me going don't charge concierge fees.

Just realize then that you won’t get any of those things on your list.

[Anonymous]

I can't wait for AI to put human "doctors" out on the streets with the trash.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hit reply too fast. Do you see how this makes zero sense? You want them to know better than you but you don’t want to do what they tell you to do.

Also if they take all those phone calls they’ll never have time to actually see patients in person and also they won’t get paid. Sucks but true. Your quick phone call, multiplied by 15, plus the documentation required for it, would take up hours.

There's A LOT of real estate between "makes $50k a year" and "makes $600k a year". Doctors could stop over-scheduling, spend more time with patients, take phone calls, work on bedside manner and still make what any American would consider a lavish sum. Nobody is asking them to impoverish themselves, just maybe make a couple thou less a day.

Doctors have zero control over their own schedules. Unless they own their own practice, in which case they are struggling to make ends meet thanks to the insurance industry paying Pennies on the dollar.

It looks a lot more than pennies on the dollar when I get my statements. They get hundreds for a few minutes of face time.

What percentage of what is billed do you think goes just to pay overhead to run the clinic, straight off the top, not even including malpractice insurance, maintaining licensure, etc. -- just the lights on, employees paid, and utilities?

This is true of most businesses with rent, salaries, insurance, material and utility costs. The patient is not paying pennies though. They are paying hundreds and thousands of dollars a year.

Right. So what percentage do you think thatis, for a medical practice?

How can I tell? Are you in Manhatten or Front Royal, which affects rent and salaries. What kind of doctor are you - OB-Gyn or dermatologist or PCP, which will impact insurance premiums. Are you a concierge doctor or part of a hospital system? How many support staff do you employ? How long do you spend with each patient?

I don't know the answer to these operating cost questions for my tree service or local supermarket either. Why don't you provide these figures to us?

So you're judging the cost and assigning salary, without any sense of what the average overhead is for a basic medical practice? Okay.

Sure, if you want to know, I'll pull it for you. I'm still interested in what your guess would be. I think it would be informative. FYI, it's different for medicine than most small businesses, for various reasons of specific responsibilities, liabilities, and constraints.

I'm interested if you diagnose your patients without doing any tests or asking the patient any questions. Yet you want to DCUM users to guess overheads without providing any data about your practice's income and costs. Do you diagnose on averages or is each patient different?

NP here but I’m guessing you’re the one who wants this info. And you want the PP, doc, to give it to you for free while you sit there. This sounds all too familiar. If you want to know overhead costs for medical practices, google it. The doctor isn’t your butler.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hit reply too fast. Do you see how this makes zero sense? You want them to know better than you but you don’t want to do what they tell you to do.

Also if they take all those phone calls they’ll never have time to actually see patients in person and also they won’t get paid. Sucks but true. Your quick phone call, multiplied by 15, plus the documentation required for it, would take up hours.

There's A LOT of real estate between "makes $50k a year" and "makes $600k a year". Doctors could stop over-scheduling, spend more time with patients, take phone calls, work on bedside manner and still make what any American would consider a lavish sum. Nobody is asking them to impoverish themselves, just maybe make a couple thou less a day.

Doctors have zero control over their own schedules. Unless they own their own practice, in which case they are struggling to make ends meet thanks to the insurance industry paying Pennies on the dollar.

It looks a lot more than pennies on the dollar when I get my statements. They get hundreds for a few minutes of face time.

What percentage of what is billed do you think goes just to pay overhead to run the clinic, straight off the top, not even including malpractice insurance, maintaining licensure, etc. -- just the lights on, employees paid, and utilities?

This is true of most businesses with rent, salaries, insurance, material and utility costs. The patient is not paying pennies though. They are paying hundreds and thousands of dollars a year.

Right. So what percentage do you think thatis, for a medical practice?

How can I tell? Are you in Manhatten or Front Royal, which affects rent and salaries. What kind of doctor are you - OB-Gyn or dermatologist or PCP, which will impact insurance premiums. Are you a concierge doctor or part of a hospital system? How many support staff do you employ? How long do you spend with each patient?

I don't know the answer to these operating cost questions for my tree service or local supermarket either. Why don't you provide these figures to us?

So you're judging the cost and assigning salary, without any sense of what the average overhead is for a basic medical practice? Okay.

Sure, if you want to know, I'll pull it for you. I'm still interested in what your guess would be. I think it would be informative. FYI, it's different for medicine than most small businesses, for various reasons of specific responsibilities, liabilities, and constraints.

I'm interested if you diagnose your patients without doing any tests or asking the patient any questions. Yet you want to DCUM users to guess overheads without providing any data about your practice's income and costs. Do you diagnose on averages or is each patient different?

No, it's just a simple question. The average doesn't vary as much as you seem to think, and yet the complaints here are not about single, specific practices -- for the most part, they are about doctors in general.

It's interesting, that's all. I wonder if anyone would have gone with 65-70%?

I’m a dentist (although in public health, not private practice). Dental overheads typically run at about 75%. And people wonder why dental fees are so high.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had an orthopedic give me his personal phone number and take my phone call midday, and let me text X-rays to him to get a 2nd opinion within 1 hour.

I don’t even really expect that but dang that was amazing.

+1. My breast cancer surgeon did this. Being able to ask Qs by text opened up important opportunities in my care.

It would be nearly impossible for an employed primary care doctor to do this work upwards of 3000 patients. Many are going concierge to bring that down to 200-400 and they do give out their numbers. So based on this thread I anticipate more and more concierge doctors. It seems that’s more the care that both doctors and patients want.

Right. The experience of a breast cancer surgeon is going to be different than that of a primary care doctor with 3200 patients. The surgeon is unlikely to be called about requests for refills on meds that require monitoring (but the patient hasn't had a blood pressure on record in over a year), or called at Sunday lunchtime with a request to "get on disability," or a thousand, thousand other things. Their time is treated differently.

[Anonymous]

Anonymous wrote:I can't wait for AI to put human "doctors" out on the streets with the trash.

Okay. Be sure to sign up for it as soon as you can.