People make money referring patients to dr offices

I was chatting recently with a doctor friend referrin was depressed because he thought he had lost a referral source. And this month only one patient. He threw up his hands, exasperated by my obliviousness. He developed a relationship with another cardiologist. I smiled at the overwrought response, with its connotations of a romantic breakup. But to my friend, this was no joke.

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Ethical implications include the following:. Paul T. The reason is fundamental and clear. This is because the hospital has created a financial incentive to physicians that is not based on what is the best care for the patient. Declining revenue for hospitals and physicians is likely a contributing factor to the recent kickback incidents. Doctors that want to ignore the law are resorting to this. Competing insurers, and even Medicare, are trying to hold down costs. The use of physician networks is becoming more prevalent. He points out that few patients ask physicians if they have a financial incentive to prescribe a particular medication. Menzel says that before the kickback incidents were widely reported, most patients probably never even considered their physician might get some type of incentive for a referral. But without asking them, few think of it. The Physician Payments Sunshine Act requires that financial relationships between physicians and industry be made public.

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For more information, visit: www. If hospitals feel competitive pressure to participate in unethical practices, a joint approach might be called for. Hospital administrators might otherwise turn to kickbacks in order to get a leg up on the competition, or simply survive. On the other hand, if these trials yield convictions, hospital CEOs are likely to stand up and take notice — thus, the practice may decrease. The bottom line is that patients should not have to depend on the threat of fines and convictions to ensure physicians put their best interests first, says Menzel.

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It’s early Tuesday morning and Ashleigh McKenzie is behind the wheel of her Toyota Sequoia, iPhone in hand, squinting as she navigates the rural back roads of southwestern Alabama. The petite, energetic blonde has a full day of doctor visits ahead — and the first one, she says, is «kind of out in the boonies. So after greeting the front-desk staff with a cheery «Hey, y’all! The appointment starts with a little get-to-know-you chitchat, during which McKenzie learns that this internal medicine doctor, who started her practice a few months earlier, is already busy with a growing roster of patients. In the sports-crazy South, the newly minted M. And of course, U. In short, plenty of folks who might need to be referred to a specialist. All good news for McKenzie — because even though she is nursing a lingering cold, that’s not what brings the year-old University of Alabama grad, stylishly turned out in a black dress and triple strand of pearls, to the small town of Bay Minette population: 8, She’s making the trek as a principal of AdvisorsMD, one of a small but growing number of health care consultancies around the country that promise to help specialist physicians reel in more referrals by marketing their services to fellow doctors. In this business, it’s all about pitching one doctor to another — often without one having seen the other in action, or face-to-face. On this morning, McKenzie is promoting two clients: a doctor orthopedic group trying to fend off a nearby competitor and a solo urogynecologist who handles pelvic and bladder issues.

A little-known profession that just might influence which doctor you see next.

In the social media age, health care providers have taken heavily to Facebook, Twitter, and other platforms in order to reach potential new patients. Others, including dentists , might opt for the old-school method of investing in local television or billboard advertising, spending thousands in the hope that blanketing a community with stock photos of pearly-white smiles will reach that small percentage in the market for a new caregiver. Does any of it work? To varying degrees, it does. But in the realm of non-primary health care, there is nothing that provides as much benefit in relation to its comparatively small cost as a patient referral program. Unlike mass advertising, there is virtually no waste on disinterested parties. A patient referral program is a marketing system designed for health care providers who recognize that new patients are key to growing their practice. The second card is a regular business card. This invokes the law of reciprocity, Winans says. Dentists, physical therapists, optometrists, and other providers who have impressed a patient are virtually guaranteed to see new patients come in a result of this practice. Depending on your state, however, having a giant sign in the lobby promising money for referrals might be frowned upon. Some want to farm it out. Financially, implementing a patient referral program in your practice is extremely affordable.

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I don’t cr See results. This is used to provide traffic data and reports to the authors of articles on the HubPages Service. The insurance company could have dropped your doctor because he doesn’t have enough patients on his practice for that insurance plan to continue keeping him on. The goal is to help doctors learn how to treat obesity and serve as a resource for patients seeking doctors who can look past their weight when they people make money referring patients to dr offices a medical problem. Rachael O’Halloran. Prescriptions Do you feel that a doctor has to give maek a prescription for something to remedy the reason for your visit? I’ve rarely been sick a day in my life, am a good risk as far as insurance companies are concerned but yet I have to pay very high rates for health insurance because of where I live California at present, soon to be Virginia in about 2 months.

More primary-care doctors work directly for hospitals, and they are being pushed to keep lucrative referrals in-house

In a little departure from the usual topics and format for my «Spotlight On» hubs, this hub can be considered:. In the United States because that’s where I livehow we receive health care has changed a lot over the last ten years. I hate to start out with a lot of questions, but please be patient no pun intended with my polls. Your answers will actually provide other readers with good information so they can evaluate how good or bad their medical care and health insurance really is.

At the end, I’ll post screenshots with the latest survey information as of January pertaining to most of the poll questions. While doing this, they must still maintain paper charting for up to ten years or until The federal government gave these healthcare providers monetary grants to buy electronic technology for their practices.

The money was paid to them out of funds from the Recovery Act of and the health care law budget. By actively using technology to show this, they were considered to have demonstrated «meaningful use. By the end ofmore thanproviders and 3, hospitals have received incentive payments because they are meaningfully using electronics in their practices.

Source: USA Today. Click on the following two graphics to enlarge. It shows the percentage of cooperation and what each doctor felt were the benefits of using electronic charting. Click on the next two graphics to enlarge and see exactly how much money each healthcare provider got. I hope you will be as amazed as I was when I read these amounts. I don’t know about you, but with all that money being paid to these doctors, I don’t see very elaborate electronics or technology in use at any of MY doctor’s offices.

What do you see at your doctor’s office? I see each nurse practitioner, physician assistant and doctor partner with a laptop and I see the expected office equipment that I’ve always seen in my doctor’s offices.

Hopefully the poll results have given you a little peek into how other readers view the quality of their medical care and the way they receive it. And oh my gosh, I hope you weren’t the first person to answer the polls, so that there’s no other results for you to see yet! If you were the first person, please share this hub with your followers so more readers will have participated. The next time you come to this article, the results will have been updated. Click «follow» on this hub so you get email notifications.

Now, why did I ask all those questions? Because I wanted you to voice your opinions but I also wanted to show you various pieces of information I found so you would get as mad as I am! Merritt Hawkins is a national physician search and consulting firm. They conducted a survey of medical offices and tracked how long the average patient needed to schedule a NEW patient appointment in 15 of the largest metropolitan cities in the US. See graphics for more detailed information.

Have you noticed that your wait in your doctor’s office waiting room has changed over the last few years? Is the actual time spent with your doctor in the exam room much shorter now? If you answered yes, it is not surprising, given the number of patients a doctor has scheduled each day at his office. With the new medical insurance plans offered through the health law’s exchange website, doctors are finding that insurance companies want to pay them less money but want to send them large numbers of patients.

Doctors who are concerned with payments generally provide less actual patient services in person, but are able to charge for using the time and services of other professional billable personnel, like EKG technicians, phlebotomists, physician assistants and nurse practitioners.

In a typical fee for service office practice, the doctor is rewarded for seeing patients in bulk. He has to decide how many patients to see in a typical day of office hours, decide how much time he has to spend with each patient so that patients get enough «face» time and the doctor gets enough «billable» time, and then balance this patient load with his out of office commitments surgeries, procedures, clinic or hospital time, family time and still be able to run a profitable practice.

How many times have you sat in a doctor’s waiting room to hear someone complain about how long they are waiting to see the doctor? Probably more now than ever. How many times have you learned that your appointment which was scheduled for say 3PM has another patient scheduled at PM and yet another at PM? With patients complaining of long waiting room times and short actual one on one face time with the doctor, many practices are using nurse practitioners NP and physician assistants PA to help them see more patients per day which cuts down on patient frustration regarding waiting room wait times, provides time addressing their complaints and allows for the ease of getting a «sooner rather than later» appointment to be seen.

This is so prevalent now in the US, that every 3rd or 4th office visit actually results in seeing the doctor whose name is on the door, while all other visits utilize the billable professionals. Some practices have also used nurse practitioners or physician assistants to creatively and legally bill insurance companies for a patient visit.

They make a patient see the NP or PA first, who takes their history or reason for visit, and then they make the patient go through the whole thing again when the doctor comes into the exam room to see. One of the reasons doctors do this is because they have to document the actual use of the NP or PA in billable hours.

Another reason is a doctor is able to charge an insurance company for a different type of visit if it goes over a certain amount of time and if it uses other professional billable personnel.

This speaks to time management skills, and the lack thereof, but it also speaks to struggling to meet their bottom line, which is to pay their overhead, pay their staff and still keep their office doors open with what they receive as payments, either from direct pay patients or from insurance stipends.

A stipend is a guaranteed amount which the health insurance company has agreed to pay the doctor or health care provider as per patient, per service and per length of visit.

Doctors had to give managed care networks discounts on their office visit rates and to reciprocate, the managed care networks sent more patients their way to make up the difference. By scheduling as such, he can give every patient an appointment, so no patient can say they were denied an appointment date within a reasonable amount of time.

The heck with whether they are getting actual care from him personally at the appointment, but they are getting an appointment with «a health care professional. If he gets enough of these submitted to insurance companies per month, he can afford to take a few extra minutes to. Fact: If a doctor accepts a lot of medical plans, if he does not have enough patients who are on each plan, he is not making a truckload of money.

If a doctor is not making money, his business will fail. If he doesn’t see enough patients in the course of a day or a week, he is not going to make enough money to cover his employee and business expenses rent, salaries, office equipment and still have take home pay to support his family. Add in how much managed care insurance actually pays a physician versus how much he would make with private paying patients and you have a doctor who is going to increase his patient load to accommodate the patients who use a medical insurance as their primary way to pay their doctor.

The only way he will make more money over and above the insurance stipend is if the patient has a copay varies according to the plan which he gets to.

Usually even then, if the doctor has a practice with many patients who have one particular medical plan, he will receive even less of a stipend per patient because he has more participants paying the copay per visit. This is why you will see each year around Medicare enrollment time October to November that your doctor’s name is no longer on the provider list. You can get mad at the doctor assuming they are at fault for not taking your insurance any more, but it could very well be the other way.

The insurance company could have dropped your doctor because he doesn’t have enough patients on his practice for that insurance plan to continue keeping him on.

They get it on both ends — from your monthly premium and by not paying high stipends to the doctors who accept their plans as part of their professional «business.

When a doctor removes a health plan from his list of providers, he is not thinking about how many people will be impacted by his decision, because it is «business. He has to do whatever it takes to keep income flowing to be able to meet his overhead and support his family. Unless you can afford to pay his going rate, your best bet is to ask for a list of insurance companies he does accept and get the number not the names of patients on that plan. Then choose the plan with the highest number of patients.

He is more likely to keep that plan on his list because it is making money for him with copays and by stipends paid by the insurance company. The actual amount of time your doctor spends with you in the exam room or his consultation office has a direct impact on his earnings.

You might be thinking you waited three months for the appointment and took the afternoon off from work, that you now wasted two hours in the waiting room and have a long list to refer to for your appointment. But the doctor is thinking, «I’ve only got ten minutes with this patient because I have to see at least three more in this hour in order to keep my earnings in line to pay for my expenses. If he wants to make any headway, he will have to conduct shorter office visits, and many more of.

Patient centered means you have a team of health care professionals and you share in the decision making process for your treatment plan and ongoing care. Your doctor invites your questions and answers to participate in your visits and if he is not available, there is always someone who «knows you» whom you will have access to and will be able to provide for your needs.

The relationship between a doctor and patient very much determines the outcome of any treatment plan. Huffington Post — Slideshow of all 52 states in order of longest wait times to shortest wait times. One doctor blames patients for long wait times — lateness, emergency delays and Oh, by the way! O verheard while waiting at the doctor’s office.

Health insurance — how it all works. Why is your doctor typing? Blue Cross Blue Shield — what to consider when choosing a healthcare plan. Making you feel that you have been heard is very important because if you don’t get the chance to say what you want to say with or without referring to notes or a listyou won’t feel like you got your money’s worth in the fifteen or less minutes it took to get through your long-awaited doctor’s visit.

In the end, it is not really the amount of time the doctor spent with the patient, because a short visit can be just as productive as a long visit. It is how the doctor made the patient feel by the end of the visit as he is walking out the door. That will determine if he will ever return for another visit, or if he will go in search of another physician. To comment on this article, you must sign in or sign up and post using a HubPages Network account. I try not to have selfish motives in my writing, and although no one has ever said that, it will be something I watch out for a little more closely.

Your enthusiastic comment is appreciated, but if this is the first hub of mine you have read, I invite you to read others because clearly this is not my best work lol. I will definitely check out some of your hubs and follow you. Thank you for following me and your generous votes. You have such a gift for writing.

Just use it without a selfish motive and no telling at how far you will go and how many people you will touch. Doctors are supposed to teach patients, but in this case some doctors need patients to teach them that time is money for everyone, not just.

Long waits should not be happening given all the personnel in the office, the electronics to make each task easier, and the level of education each person has to be able to do their jobs more efficiently.

It is more likely the system that may need overhauling, not necessarily the people in it. Unfortunately we have to work within a system that is already in place. It is not a perfect system but it is the one we have at the moment. Making it work for us — the patient — until something else comes along is the long term goal.

This was an interesting approach to healthcare concerns of Doctor visits. The present goal is to shorten waiting time for patients and I do hope it improves over time. Love your poll questions and the current trends in waiting time you posted. While my other healthcare hub centers on incentive payments for doctors by switching over to electronic patient records EHR from paper records, I also will be interested to see if there will be evidence that incentive payments ended up being money well spent.

Hospitals Wary of Penalties

Primary-care physicians, the first line of defense in our battered health-care system, get notoriously small reimbursements from insurers, a problem that has gotten worse in recent years. How hard is it to stay in business as a private-practice primary-care doc? Here, he walks through his expenses and revenues. Kenworthy set up shop in Byhis practice had grown to about 4, patients. According to Kenworthy, since aroundHMOs have been aggressively peoople back what they pay primary-care doctors. Bydiagnostic tests were just 30 percent of his income.

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The rent has gone up by about 15 percent since. Kenworthy mailed them a thoughtfully worded pitch and got zero response, which de the end of his direct-marketing patiengs. He gets generally good Yelp reviewsbut he turned down an offer from an online-reputation company. Level 1: 10 minutes. Blood-pressure check : The most basic visits, like blood-pressure or blood-sugar checks, take only people make money referring patients to dr offices few minutes. Insurers classify these as Level 1 reerring. Level 2: 15 mke. Level 3: 30 minutes plus. Physical checkup: About 95 percent of his concierge patients see above come in for an annual checkup. To avoid the hassle, he bills physicals at Level 3, checking a few boxes on a single-page billing sheet for each patient. Multiple chronic problems: Kenworthy still sees very sick patients who require testing.