Physicians Practice - March 2008 - (Page 16)

LETTERS Perhaps many of us have these feelings of resentment and bitterness that underscore our view of the income we have. Perhaps all the time we lost with friends and family during training, the worry, the doubt, the constant concern of a possible lawsuit from day-to-day practice, and all the stress of a medical career together takes its toll on us and prevents us from being nothing less than “disappointed” with our income, no matter the actual number. I’d like to see some articles discussing that. ﬁve times the amount of money in his 401(k). If we both continue saving at the same rate and we both retire at age 65, I will never catch him with regards to retirement wealth. Keep in mind that he saves 6 percent with a company match and I am saving $20,000 per year in my 401(k)! While it is true that physicians earn signiﬁcantly more, it is also true that the earliest you can begin to save for retirement is age 30. Believe me, I am not complaining about my income or quality of life. I feel very fortunate and blessed to have the income sound practice and attention to detail, they can never be eliminated. In medicine/surgery, complications happen. When they do happen, it is not always the fault of the healthcare providers. Still, these complications need to be managed and this takes time and effort. Physicians and hospitals deserve to be compensated for this. Do you honestly expect me to work for free? Do you work for free? Medicare/Medicaid and other insurers may get away with refusing to pay for care related to managing such complications for now, but if this trend continues (along with projected continued overall reimbursement cuts), we will eventually get to the point where physicians will decide it is no longer ﬁnancially feasible to contract with Medicare/Medicaid or private insurance in general. In my opinion, this “Atlas Shrugged” scenario is exactly what needs to happen. —Kevin W. Watson, MD Salisbury, N.C. Medicaid will never work, and there will always be shortfalls that the administrators and politicians will blame on doctors. The system cannot possibly work because there is no real cost to the patient so the patient doesn’t have to choose whether a certain treatment has value to them and how much value it has compared to other things the patient might want. This is basic microeconomics. The cost of the service must equal the value that the patient attaches to that service. Since the cost to the patient is zero, the demand for services is inﬁnite. The only way that Medicaid can hope to work is through HMOs with strict gatekeeper systems. To ensure that patients aren’t denied appropriate care, some sort of ombudsman or appeal service is warranted. The current system, however, will never work because the basic economic laws that make a market system work are circumvented. Doctors need to start saying this instead of playing “wack-a-mole” with the politicians’ latest complaint. —W.S. Grizzard, MD Tampa, Fla. WWW.PHYSICIANSPRACTICE.COM IT’S ONLY FAIR “I am already working at absolute maximum capacity in my schedule. I work 12-hour days most of the time. Do I deserve a decent income? I think the answer is yes. I sacrificed long and hard to make it through training.” that I have. I just wanted to add the retirement savings piece as something that often gets left out in these discussions about physician income. —F. Allen Hewett, MD Raleigh, N.C. Interestingly, I come from a family that hates physicians because of the perception that doctors have piles of disposable money just lying around, so therefore they must not deserve it. I am glad I grew up poor, because it taught me how to budget, but I think the general public needs to understand that we’re not on Easy Street just because the degree is on the wall. —Krystal Johnston, MD Manistee, Mich. I read with interest “How Much Is Enough?” in the October issue. I am 35 years old and have been out of residency for ﬁve years. I am a pediatrician in a private practice. Recently, I had an interesting discussion with my college roommate, who is a computer engineer. At age 22, he started his job and started saving for retirement — a full eight years before I started saving. While my salary is triple what he makes, he has 16 | PHYSICIANS PRACTICE | MARCH 2008 CAN IT BE FIXED? In your January editorial “Fixing Medicaid,” you stated that it was hard to argue with the rationale for Medicare’s decision not to pay to treat hospital-acquired infections. You ask, “Why should taxpayers have to pay healthcare providers to treat ailments caused, in essence, by the providers themselves?” The question you pose demonstrates a lack of understanding of managing sick patients in the hospital setting. What you have to understand is that although complications such as central line infections, ventilator-acquired pneumonias, and surgical wound infections can be minimized with http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - March 2008

Physicians Practice - March 2008 Contents The Bigger Picture: Try a Little Tenderness Second Opinion Letters Physicians Practice Pearls: The Value of First Impressions Noteworthy Cover Story: Your Complete Guide to Patient Service Billings & Collections: Rules to Code By The Administrators Desk: Selecting an EMR Technology: Learn to Love Your Nerd Ask The Experts Coding The Guide The Tech Doctor: All About Blogs The Great Practice Makeover: When Bad Things Happen to Good Practices Start It Up - NEW! The Law: Audits 101 In Practice: Do As I Say... Pretty Please? Healthonomics: Handling the Changes Wrought by Medicare D Classifieds Advertiser Index

Physicians Practice - March 2008

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