Dinner at a doctor friend’s house is always an interesting
phenomenon. You learn the heartaches and the travails of another colleague and
spend time commiserating the evening away. You also learn in the process of
what has transpired in their field of medicine. Any and all new developments
are bandied about and a roughly drafted thought of what helps and what doesn’t,
seems to stick.
The other night, it was orthopedics. You know, my friends
who use buzz saws and staples, as they set broken bones straight. Yes, those
wonderful human beings who spend an inordinate time washing their hands in the
sink before they enter the theater. Oh I recognize their superiority in their
art and the unsaid aplomb admixed with the tension of time constraints,
sometime insufficient supplies or inadequate trainees gives it an air of a
theatrical performance. All said and done, most perform admirably in setting
things straight.
So I learnt that the orthopedic surgeons have seen a drop in
their income. But not to despair, I said, it is happening in all specialties
across the board. No he says, the NYT states that we are making more money than
last year. Ah yes, that determination is based on one’s billing or revenues and
not based on the Net Income. Yes, he says, that’s probably true. You know, he
wonders out aloud, what will become of medicine? I ponder on the subject,
staring intently at the glass behind the elegantly furnished bar in the
basement of his house. I look up to answer and find that he is gone, shaking
hands with another. Ah yes the art of company and being a host.
What will become of medicine? I wonder. But the wall in
front of me is bare except for this tiny framed English painting of a foxhound
hunt. And for a brief moment this painting clears the foggy view but then it is
gone.
The dinner call comes and slowly we all fall in line to
climb the stairs to his dinning room. Nothing ostentatious here, a table for 10
with place settings and in one corner a Roomba ready and “green” with desire to
clean every dirty speck that came crawling in underneath every guest shoe.
The dinner is quiet with the clinking of stainless steel
ware and the china and from across the room a friend of his shatters the quiet
reverie. Hey, he says, did you notice what these PAs and NPs are doing? Boy! He
sniffs, are they raking it in. What do you mean, my friend asks. Well, the
other guy says, I operated on a arthritic hip the other day and I received my
usual $1500 for the total hip from our bountiful masters. Meanwhile this
non-par NP receives $2900 for assisting me and also has the temerity to
balance-bill another $500 to my patient. I mean, what the hell? Really? My
friend asks with incredulity. Yeah, so we started looking at all the surgeries
done with these “providers” and in a 100% of the cases they were paid double if
not triple of what I got paid for the surgery. Incredible! He gulps down his
class of water trying to force the chicken he has swallowed, down the gullet.
Oh, he exclaims after swallowing, the podiatrist who assisted me the other day
got three times of what I got. I complained to him, and he smiled back at me. Well, he said, those are the chinks!
My friend now slightly agitated asks his wife, Honey! Could
you check our explanation of benefits and see what is going on. Yes, she says
she will.
Needless to say that the desert tasted a little out of
sweet, to my friend and maybe all of us assembled, that night. The night ended
with pleasantries as all dinners do and as I got back in the car the only
thought ringing in my head was, what the hell is going on under the guise of
Healthcare?
While the overhead costs for these surgeons has reached
70-80% their struggle to continue serving patients is making them run like
hamsters. And hamsters can run but not think, you see! The programming is well in its final phases and you can run but cannot hide.
No comments:
Post a Comment