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CMPA fees by specialty

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While browsing CMPA fees (here) I found that Neurology seems like a bit of an anomaly...am I reading this right? Does someone have an explanation?
Neurology: 22,400
Cardiology: 8,400
GI: 8,400
Nephrology: 5,208
Psychiatry: 5,208

Why would neurology be in the same bracket as gen/cardiac/gyn/plastic/thoracic/vascular surgery. It's weird that neuro would have to pay ~3-4x what other medical specialties pay, while billing ~1/2 as much (although I'm aware that the CMPA doesn't set fees based on income).


 

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My understanding is that the rates are based on the cost of settling/paying out past lawsuits against members of that specialty.  This is just an educated guess of why neurology is high, but bad neurological outcomes can have very high morbidity (stroke, etc) without death which can leave patients requiring very expensive care for the rest of their lives. Patients who experience bad outcomes in other medical fields probably on average don't tend to live as long after the outcome occurs.

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It's all to do with lawsuit rates. Neurology involves treating a lot of rather noticeable and often rather debilitating conditions, most of which are chronic. That this conditions are often difficult to treat, with medications with limited efficacy and/or significant side-effects. It's a combination ripe for lawsuits, as you have a lot of patients who are frustrated and debilitated.

Compare that with the most common conditions in Nephro, Cards, or GI - they're often silent for long periods. When they do present themselves, these specialties have options available to improve symptoms to the point that patients feel better (even if their underlying conditions are still quite dangerous) Especially Nephro and Cards, half the challenge is convincing patients who feel fine to do the preventive things to keep themselves feeling fine.

Also, while this is certainly an over-generalization, neurologists as a group are a bit... weird. Not to say doctors in general aren't weird, but Neuro tends to take a few more of the eccentric ones. Poor patient rapport and increased miscommunications are major factors in determining lawsuits, completely independent of actual performance as a physician, so while I doubt that's a major factor for neurologists, wouldn't surprise me if it added a couple hundred bucks to their annual fees :lol:

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On 3/26/2018 at 10:52 AM, Monkey D. Luffy said:

OBS Gyn Staff have to pay 82k per year for CMPA fees?! I knew it was high but that's insane.

by far the most commonly sued specialty. People dont like it when babies turn out wrong lol

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On 3/26/2018 at 10:52 AM, Monkey D. Luffy said:

OBS Gyn Staff have to pay 82k per year for CMPA fees?! I knew it was high but that's insane.

 

10 minutes ago, beeboop said:

by far the most commonly sued specialty. People dont like it when babies turn out wrong lol

Obsy/gyn doesn't actually pay it. They have a special agreement where the value is paid to them by OHIP a few days before its due.

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At least in ON the provincial government covers a percentage of the fees. Nontheless ob/gyn pay a higher absolute amount compared to other specialties. It's unfortunate because people have a distorted view that pregnancy and birth should be a benign, joyous journey. But if anything there are so many things before, during and after pregnancy that can kill the mother or the baby. (eg. molar pregnancy turning into choriocarcinoma, placental site trophoblastic tumor, amniotic fluid embolism, post partum hemorrhage, DVT/PE, HELLP, etc etc)

http://www.health.gov.on.ca/en/pro/programs/ohip/mlp/default.aspx

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On 3/27/2018 at 4:19 PM, shikimate said:

At least in ON the provincial government covers a percentage of the fees. Nontheless ob/gyn pay a higher absolute amount compared to other specialties. It's unfortunate because people have a distorted view that pregnancy and birth should be a benign, joyous journey. But if anything there are so many things before, during and after pregnancy that can kill the mother or the baby. (eg. molar pregnancy turning into choriocarcinoma, placental site trophoblastic tumor, amniotic fluid embolism, post partum hemorrhage, DVT/PE, HELLP, etc etc)

http://www.health.gov.on.ca/en/pro/programs/ohip/mlp/default.aspx

Does family physicians who do obstetrics as part of their practice pay higher fees for CMPA?

I am just wondering, as the billing codes for FM-obs and Obs-GYN for deliveries and c-section are the same. I wonder if FM-obs pay higher in terms of CMPA insurance thanks

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2 hours ago, LittleDaisy said:

Does family physicians who do obstetrics as part of their practice pay higher fees for CMPA?

I am just wondering, as the billing codes for FM-obs and Obs-GYN for deliveries and c-section are the same. I wonder if FM-obs pay higher in terms of CMPA insurance thanks

Type of Work Code 78.

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