One in six newly graduated medical specialists can’t find work

[seeking1]

One thing I've noticed over the years is that the fee codes tend to favor procedures that involve the use of state-of-the-art (aka relatively new to market) technologies over old-school methods. It's one thing that explains why an ophthalmologist gets paid more than a general surgeon, or why radiologists get paid so well.

 

The valuation has nothing to do with impact on patient health.

 

Whichever entity sets the fee codes is probably heavily influenced by corporate lobby groups who want to see returns on their investments into the development and marketing of new gadgets. Inflating the fee codes increases the likelihood that these new techs will be bought, utilized, and made the standard of care.

 

If what I say is true, then we will never see GP, psych or other E&M-style fields reach any type of respectable pay level, and we will never see the fields with the overinflated fee codes see any substantial reductions.

 

Basically this.

[aaronjw]

Some of you are so clearly blinded by your entitlement beliefs if you think GPs, psych, etc not already having respectable pay levels

[Med0123]

Some of you are so clearly blinded by your entitlement beliefs if you think GPs, psych, etc not already having respectable pay levels

 

GPs making an average of 300k =

I mean I see no problem that SOME GPs make >300k (e.g. obgyn call, rural area, lots of ER call, etc.), but when the average compensation is 300k in some province, it causes a big hole in the ministry of health physician compensation envelope.

[rmorelan]

GPs making an average of 300k =

I mean I see no problem that SOME GPs make >300k (e.g. obgyn call, rural area, lots of ER call, etc.), but when the average compensation is 300k in some province, it causes a big hole in the ministry of health physician compensation envelope.

 

that isn't the average salary, maybe average billings - out of that comes a lot of costs (the office, the staff, the supplies, accounting, etc,etc,etc).

 

Gross billings is not take home salary

[bloh]

The average GP doesn't make 300k though. The Average billing of a GP is 200-250 depending on the province. Once you subtract all the expenses you can make more driving a truck in northern Alberta with no education.

[Dongzhuo]

GPs making an average of 300k =

I mean I see no problem that SOME GPs make >300k (e.g. obgyn call, rural area, lots of ER call, etc.), but when the average compensation is 300k in some province, it causes a big hole in the ministry of health physician compensation envelope.

 

I find that for family medicine the billings really depend on how you approach it. If you do it the "right" way, that is you spend 40 minutes with a patient talking about their mood and how they feel about people at their work you'll make less than a high school principal. However if you approach it with a financial mindset you'll do fantastically well. A guy comes in for a work note. Takes 20 seconds. 35 dollar visit fee and 50 out of pocket. 85 bucks for 20s work!!! 700k billings are not unreasonable in family

[apache]

you get what you put into it... push yourself to the next level and there are ample opportunities for product development in business, offshoot private enterprise. Write, create a new diagnostic product, create a new diagnostic solution, run a public health promotion company... develop a novel non-pharmacological treatment based on biotech and your knowledge of your field and extensive research abilities... i'm loving the way alberta is taking education and incorporating it with innovation

[Der Kaiser]

government can be a lot more direct than that - just simply cut all opthos residency positions for the next three years (as an example - not saying actually do that! ). Blunt, brutal, but quick. Not saying they would but if they want more FMs they can do that pretty easily really.

 

Doesn't fix one issue though that according to some estimates will will be in surplus FM land within a few years. We will have distribution issues but churning out FM docs won't really directly solving things either.

 

Oh and going to the US isn't quite that empty US has a specialty shortage and a lot of people write the US tests do give themselves that option.

 

What I don't get is how the US still has shortages in primary care and other specialties, yet we have fewer doctors per capita and we are talking about an oversupply (we have 2.1 per 1000 compared to their 2.4). The only thing I can think of is that because we have a one payer system the government artificially restricts supply so even when demand increases we can still have doctors without work because there is no OR time or funding for hospitals, etc.

[aaronjw]

I find that for family medicine the billings really depend on how you approach it. If you do it the "right" way, that is you spend 40 minutes with a patient talking about their mood and how they feel about people at their work you'll make less than a high school principal. However if you approach it with a financial mindset you'll do fantastically well. A guy comes in for a work note. Takes 20 seconds. 35 dollar visit fee and 50 out of pocket. 85 bucks for 20s work!!! 700k billings are not unreasonable in family

 

$50 out of pocket? Where are you getting this figure?

[Let'sGo1990]

$50 out of pocket? Where are you getting this figure?

 

He's a family med resident. Not sure which province, but in Ontario docs tend to charge $20 for notes rather than $50.

[Dongzhuo]

$50 out of pocket? Where are you getting this figure?

 

We do this routinely at the clinic

You can charge anything. Free market. As long as people are willing to pay for it you can technically charge anything for non insured services like notes

[Mighty Molar]

A guy comes in for a work note. Takes 20 seconds. 35 dollar visit fee and 50 out of pocket. 85 bucks for 20s work!!! 700k billings are not unreasonable in family

 

That's a lot of money you guys make. There is no way we dentists could match up with MD(s) in terms of money So why are you still unsatisfied? You basically rolling in cash and enjoy the prestige of an MD. Must feel pretty awesome.

[futureGP]

We do this routinely at the clinic

You can charge anything. Free market. As long as people are willing to pay for it you can technically charge anything for non insured services like notes

 

lol

 

if you work near a university at a walk-in, come exam time

[youngdad]

Family med..... for the win!

[bloh]

That's a lot of money you guys make. There is no way we dentists could match up with MD(s) in terms of money So why are you still unsatisfied? You basically rolling in cash and enjoy the prestige of an MD. Must feel pretty awesome.

 

Because he's full of **** and overexageratting.

[donnadee]

That's a lot of money you guys make. There is no way we dentists could match up with MD(s) in terms of money So why are you still unsatisfied? You basically rolling in cash and enjoy the prestige of an MD. Must feel pretty awesome.

 

lol i doubt 700K in Fm is the norm just as 1-1.5mil as a GP dentist is not the norm..both numbers have been achieved but often require lots of dedication, hard work and in unfortunate cases, cutting corners.

[Dongzhuo]

Because he's full of **** and overexageratting.

 

Are you sure?

[Dongzhuo]

That's a lot of money you guys make. There is no way we dentists could match up with MD(s) in terms of money So why are you still unsatisfied? You basically rolling in cash and enjoy the prestige of an MD. Must feel pretty awesome.

 

I agree with other posters that it's not the norm. But it can be done. But in family it's either do a good job and make little, or do a relatively poor job and make the big bucks. I blame the government's pay schedule

[aaronjw]

We do this routinely at the clinic

You can charge anything. Free market. As long as people are willing to pay for it you can technically charge anything for non insured services like notes

 

1) you make it seem like all patients require uninsured services like notes, phone refills, etc.

 

2) it is not a free market in Ontario. The expectation of fees for uninsured services in Ontario is that they be reasonable. While reasonable is ambiguous I'm willing to bet a case could be made that charging $50 for a note that took 20 seconds to write is seen as unreasonable. You're exasperation at being able to charge that $50 for the 20 seconds of work doesn't help your case either

[rmorelan]

1) you make it seem like all patients require uninsured services like notes, phone refills, etc.

 

2) it is not a free market in Ontario. The expectation of fees for uninsured services in Ontario is that they be reasonable. While reasonable is ambiguous I'm willing to bet a case could be made that charging $50 for a note that took 20 seconds to write is seen as unreasonable. You're exasperation at being able to charge that $50 for the 20 seconds of work doesn't help your case either

 

or even it is a free market and if you charge people too much for notes they will just find another family doctor - and yes, now we are in the job environment where that is actually possible to do

 

The field has to be very careful - you gouge people and eventually the profession pays for it with fee reductions and public outcry. There is always a reaction.

[uwodesperate]

lol

 

if you work near a university at a walk-in, come exam time

 

Oh boy... My friend works in the science office at an university and he showed me the pile of medical documentations from just one day during the exams and holy moly that is a lot of mula!

[rmorelan]

Oh boy... My friend works in the science office at an university and he showed me the pile of medical documentations from just one day during the exams and holy moly that is a lot of mula!

 

ha At one university I was at the school basically rebelled against the local clinic with respect to the pile of notes he produced - interesting power struggle between the two. I always found the notes a bit odd - I mean if I am really sick getting to the clinic and waiting in room to see someone is almost an impossible chore - and yet they want actual documentation.

[NLengr]

Charging someone for small things like work notes, photocopying a test result etc. has always left me with a bad taste in my mouth.

 

There are things I can see justifying charging the patient cash for (ex. Pilot flight physicals, court paperwork that takes you signifigant time etc.) but to charge people cash for a 10 second sick note seems wrong. Especially if you can bill for the visit and its your regular patient.

[BoyInTheBubble]

I find that for family medicine the billings really depend on how you approach it. If you do it the "right" way, that is you spend 40 minutes with a patient talking about their mood and how they feel about people at their work you'll make less than a high school principal. However if you approach it with a financial mindset you'll do fantastically well. A guy comes in for a work note. Takes 20 seconds. 35 dollar visit fee and 50 out of pocket. 85 bucks for 20s work!!! 700k billings are not unreasonable in family

 

You're full of it.

 

The "right" way? Most people don't need 40 minutes of counselling. And even if they did, bill a counselling code and get paid for the extra work you put in.

 

Don't be an as shole and bill 85 dollars for a sick note. No wonder, you have no respect. In my experience, most people bill the fee code if the person is currently sick (and write the note for free), or bill for the sick note ($15-25) if the person was sick yesterday. If you spend 20 seconds you definitely shouldn't earn 35 dollars for your pretend assessment.

 

How many bad apples does it take to ruin the bunch?

[aaronjw]

Charging someone for small things like work notes, photocopying a test result etc. has always left me with a bad taste in my mouth.

 

There are things I can see justifying charging the patient cash for (ex. Pilot flight physicals, court paperwork that takes you signifigant time etc.) but to charge people cash for a 10 second sick note seems wrong. Especially if you can bill for the visit and its your regular patient.

 

I don't personally have a problem paying for such a note if it's reasonable and commiserate with the effort required. $50 as indicated by Dongzhuo is not reasonable nor commiserate with the required effort.

 

There's is plenty money to be made as a FP without such tactics. Averaging 40 patients a day allows roughly 12 mins per patient (should include time for non-direct patient care) for an 8 hour day provides around $360K/yr in gross billings and rakes into account 4 weeks vacation time with 5 day work weeks.

 

Add in some uninsured billings and you could easily be at $400K with a cushy lifestyle and good level of patient care. Thinking you can make more by screwing patients with unreasonable uninsured billings is simply greed. It's physicians like this why I think fees should be cut. As a taxpayer of services I'm happy for you to make a good living, not a greedy living and physicians wonder why there's such demand by Gov't for midlevels.