Many go into specialties because they want to deal with more challenging medical problems. Also, specialists spend 3+ years in additional training and 150K+ in additional loans, so why would they do it if their compensation does not reflect it?
Gotta argue..... care coordination if PART OF YOUR JOB! Why SHOULD there be a separate billing code? Seriously!??? It's called a labor market. That's what the job pays. I hear so much about PAY (from so many human doctors) and so LITTLE about Passion for what you do! If you want to make more money, learn a new trade, skill or other (legal) way to make more and get a job doing something else. Now my doctor is asking for $350/year just to be his patient!?!?! Poor guy,.... hope he can piece together a few pennies to feed ramen to his family tonight!
I think I wouldn't call this "doctor pay", but instead doctor generated revenue, since much of that 'revenue' also goes to paying expenses for private practice owners or in some scenarios to defray costs within a multi-doctor or multi-discipline practice.
Eric - thank you for another great video - once again - if people actually knew some of this stuff BEFORE they went to medical school - they may opt for another career path
This is terrible. I'm guessing this why people choose the specialist route over a PCP. I mean I'm sure doctors are dedicated to their career, but on the other hand, everyone wants to adequately compensated for what they do.
This tells me a lot about why my PCP & Dermatologist is not interested in finding out the root cause of my problems......and Derma is far more interested in patient cycling. My PCP is probably overloaded with work/not getting paid/and not only looks tired and burned out, but actually is. Wonder how many deaths/missed diagnoses/mis diagnoses/and just don't care because the patient is 90 YO and not going to live much longer anyway........Yes, very interesting stuff.....
Two comments/questions for you. First, why the hell are radiologists so high? The others, I can understand. But with the exception of interventional radiologists, they don't really even see patients, right? That could be a subject for another video. Second, commercial insurance also doesn't pay for patient education itself. And yet so many diseases require it, not to mention just knowing stuff in general.
Great comments. Radiology high because they can read films and bill for them very quickly. Some of the Smartest people in med school go into radiology because it is so lucrative. Thank you for watching!!
Doctor awesome video!! Did you already do the video for the controversies surrounding radiology RVUs? Also back at Compass when we did bill reviews, I thought practices and physicians income were paid based on claims submitted? How are RVUs applied to this income? Do the physicians get allocated a chunk of the business’s total income?
Nice education session again Dr Bricker this time on a broken MD work incentives system that slowly employers are becoming aware of and pushing back on. Next could be patients and families who are on HD health insurance plans that are financially painful now - they deserve a strong PCP system? The other point is that the CPT system is run by the American Medical Association and their aligned national MD specialist organizations. I agree with your "what to do?" and hope near, onsite, virtual, and direct PCP innovations take off as it is a quicker path to change than the political one to create an organization in US healthcare like the Federal Reserve that is a central, independent authority in US Financial Services to run the billing code system without financial conflict of interest as with the AMA.
Let me play Devil's advocate for a minute: Some of the specialists' procedures (e.g., a stent placement by a cardiologist) are obviously more invasive, requiring more skilled post-op recovery care from many different departments (e.g., cardiac rehab), and involve much more skilled healthcare staff to pull off than just the doctor, compared to a lot of the primary care physician interventions (e.g., a sports physical done by a pediatrician). Why should hospital systems not give more RVUs to more specialized interventions to offset the system's costs in organizing and providing all the labor & equipment resources for that care?
This is extremely beneficial, thank you for posting this. How did you get the $68 workers rvu compensation for GI doctor? I am a graduating pain management fellow. Could you tell me what the compensation per RVU would be for a pain management physician?
Great video! As an endocrinologist, I would love if you would connect endocrinologists and PCP’s as we are paid in the same way. Many would assume we are paid like specialists given that we are indeed specialists; however we use the same coding as PCP’s and are paid similarly often less due to high patient complexity thus lower volume and fewer procedures.
I'm a pain management NP. I have a base salary or $35 per wRVU. I have done some math and based on my reports they are wrong wRVU wise. Does a 99214 still equate to 1.92 wRVU for mid-levels or is it lower?
Care Coordination, and everything that is involved with this process deserves a video(s) to themselves. As an RN Certified Case Manager that has worked at the Government and Plan level, the Mid Level for the Management Service Organization MSO's and IPA. plus working directly with PCP and Specialist. The honest truth is MOST Physicians and Administrators running their practices are NOT aware of the way the US Healthcare Payer system works and does not look at the Shared Risk Contract Agreements and Delegation of Services. CMS requires "Continuum of Care" and this responsibility is often neglected by one of the above payers or shared risk organizations. This is why patients/people are falling through the cracks and this system needs to be disrupted. I suggest a virtual first comprehensive screening and engagement system that promotes preventive screening and digitally supported Clinical Care Management Programs. Perhaps a micro approach to VBC that is lead by the Practices and not watered down by the Plans. Just a thought.
In my country we are debating a legislation on pay increase for people in the hc system a big problem is comparing salaries between specialties Let's take your example, should we try and equalise pay between that gastro and the pcp? No for many reasons I won't go into On the other hand comparing the needs of a pcp with their pay seems more applicable, a pcp needs to pay off education debt, earn money for higher education and earn money to afford a house This works for a basic salary but when I heard about value based healthcare and incentives to actually achieve healthcare goals I needed to know more This is why am here to know in detail how a value based system would work
Terrific video. Thank you for spending the time to explain and break down this issue. I am a RN working in a hospital. I was wondering Dr. Bricker, in your opinion, why haven't RVUs spread to nursing cares or more broadly why hasn't the federal gov't tried to model CPT billing to capture nursing cares so that nursing, from a financial perspective, is approached by a hospital less as an expense on the hospital budget and instead harnessed as another possible source of revenue? Anyways, thanks again for your videos.
Nursing services are billed as part of LOS cost for inpatients. Nurses are an expense (resource) of the organization and do not bill for direct reimbursement.
