Sunday, April 5, 2009

Call Pay

It has been one of those weekends. It seemed that every few moments either the beeper was going off or I had to run to the hospitals. As my beeper was going off yet again in Bible study, one of my class mates made a comment that "at least it was good for the bottom line." It then dawned on me that he had no idea how doctors got paid. In fact, it seemed that most people did not have any idea. So I though I would give some of the answers.
We do not get paid by the hour. We do not get paid to answer pages or phone calls. For example last night I had several calls were people were just hoping that I would call in medications for them even though they had never been seen in the office. We do not get paid to answer calls from the ER. We also dont get paid to see patients in the ER. (If we are lucky and then have insurance we may be able to bill but this weekend I had 14 ER hits and only one had insurance.) That means that the other 13 were for free. In order to have hospital privaleges and to comply with EMTALA and COBRA we have to see anyone whom the ER calls us to see, and we have to see in follow up anyone that the ER sends us. So, as a result all this is usually for free and it costs us our time, staff and supplies. The patients of course then can always sue us! By law, we can not write off on taxes any of the free care that we provide. (Lawyers can) We only get paid when we can bill from insurance or in the rare case that the ER patient actually pays us. For the trauma patients who we don't get paid we also get the joy of having to cut our clinic schedule to be deposed as they try to sue each other and everyone else they can.

We get paid by clinic billing for our insured patients. So, we get paid to treat migraine headaches in clinic, not to take care of the girlfriend of the meth head who stuck her in the head with a steak knife at 3 am. We dont get paid to take care of the drunk who tried to play frogger and run across the interstate during rush hour. We dont get paid to take care of the illegal immigrants who were shot when they tried to invade someones house. We dont get paid when they come in the office and insult our staff, steal our supplies and the demand narcotics.

I though about how to answer my class mates "bottom line" statement, and just said, "it is good for Gods bottom line". Call isn't about the money, its about doing what is right.

1 comment:

SeaSpray said...

Hi Throckmorton -I'm sorry about your on call weekend being mostly uninsured.

I think you are right about most people DON'T know how you are paid and pretty much think you are rolling in money. Now.. you do have good incomes... but it is not fair how the things you describe are allowed to happen.

*Why can't it be a write off? It is a loss.

And the liability issue.. that is a significant factor.

I worked with med people and never heard much about how docs are paid.

But always just assumed you all were paid... and I guess never thought about it. I learned from reading the med blogs. I always respected docs... but because of med blogs I understand so much more of what you do and the responsibilities, etc and my respect is at a whole new level.

It is a calling to be a physician. I really believe that because I don't think most people could do it or would want to.

I worked with an ER doc who was also a surgeon and he told me anyone could be a doctor. He said they just have to have a good memory. Somehow...I think it is a bit more than that. :)

Well... maybe we do go to some kind of universal care/socialized care... you will get paid for everything.
So what were you studying in Bible study?

I used to go to various Bible studies but haven't in a long time... also healing prayer groups.

Theology is such a deep topic. Inexhaustible in my opinion. layers upon layers can be revealed from just one scripture because there is the historical account of something and understanding the times it was written in... but then there are deeper meanings and often connected to other verses and chapters. The scriptures are the living word in that they are for past, present and future. You could never learn everything there is to know in the scriptures... because there will always be another revelation/insight into something else. It doesn't negate what was previously learned but adds more depth to one's understanding.

I don't know why exactly... but I haven't pursued things of faith like I used to. And I very much do believe in the existence of God and my faith has brought me joy, hope and given an inner peace when life was difficult and when it was good.

I definitely have drifted and refer to myself as the prodigal daughter. And I guess for a someone who does have a sure faith...I am being stupid to allow myself to drift...or human.

But I do come alive in my spirit when a theological discussion comes up. :)

P.S. I'm sure God wants you to be paid for your work though. Perhaps it will come to you in other ways. maybe you sacrifice here... but will be greatly blessed in other areas.

I know... I digressed a gain... just a little. :)