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

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[quote=Anonymous]^^The other way out of it is to drive up income while overhead remains a fairly fixed costs. Procedures can do this, as you can bill a lot for procedures. Adding providers without adding more support staff does it, as well.

Procedure-driven practices (e.g., surgical) can buy some leeway with this. They have their own challenges, but procedures mean income, whereas talking with people tends to be a fixed cost.

On the one hand, it's awful to talk about medical care like this. It feels like it reduces people to numbers, and makes their very real and painful issues into monetary problems. On the other hand:

1. We keep getting told that medicine is just a business, it's not special, and doctors are just employees. And yes, this is what that looks like.

2. If medical practices are owned by private equity, the standard of care of patients is, by definition, not the primary concern. Money is.

3. Physicians could run their own practices when on average, overhead was around 35-45%. This was true  up to around the early eighties, but it was going up in the 90s, and that has rapidly accelerated since. It's not feasible at 65-70%, so it consumes itself. Or you go concierge, or you join a large hospital-based HMO-type practice, or you go with private equity. For the most part.[/quote]

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