Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The payment bigotry against primary care doctors

Richard Young, MD
Policy
June 23, 2014
Share
Tweet
Share

I’ve listened over the years to well-meaning people say that the general public doesn’t care about physician payments, because they think all doctors are rich and any physician who complains is just whining. This is a huge mistake on the part of people who want to have a long-term relationship with comprehensive family physicians as their primary care givers, and those who want better health care at a lower cost.

Let’s take a somewhat corny example to help illustrate the point. Imagine there were federal regulations that limited a hair stylist to one low fee, no matter how fancy the desired cut, washing, blow drying, coloring, perming, frosting, or any other desired services by the customer. First, stylists would start forcing customers to make many trips to receive each individual service allowed under the one fee. Customers would tire of this and a chronic tension would grow between the regulated service provider and the customer. Customers would always try to stretch out the visit, “Couldn’t you just add a touch of color here? or “Could you blow dry my hair real quick?”

As stylists grow older and more weary of the chronic discomfort of the mismatch between customer expectations and what the stylists are allowed to be paid for, they would retire or change jobs, and few new stylists would want to be trained to take their place.

And what if a stylist was bold enough to charge a customer for a compete and fair list of services provided in one sitting? If Medicare was the payer, the stylist would be liable for penalties, fines, and jail time resulting from the accusation that she committed Medicare fraud. The penalties and fines would not just cover the discovered “abuse.” It would retroactively apply to the previous five years of Medicare claim submissions, based on a review of ten cases.

So now when American women (and a few men) can’t find a stylist anywhere to care for their hair, might they start to care about the role Medicare and other insurance company payers that caused the shortage? I would certainly hope so. So far it hasn’t seemed to happen much as patients try in vain to find a family physician taking new patients sooner than three months out, as they drive by an endless sea of urgent care centers and free-standing emergency rooms.

One final point: I realize bigotry is a strong word, but it is absolutely accurate. In classic thinking of bigotry situations, the issue is unfair pay or working conditions for similar work. In the case of family medicine, it’s even worse than this. Family physicians deliver better care at a lower cost, but make less than all other physicians. It’s not less pay for the same work; it’s less pay for better work. And Medicare, the insurance companies, and the American Medical Association are squarely to blame.

And patients and payers should begin to really care about this, unless they want to continue to pay exorbitant costs for crappy, inconvenient, impersonal health care.

Richard Young is a family physician who blogs at American Health Scare. 

Prev

What are some of the characteristics of healers?

June 23, 2014 Kevin 0
…
Next

The one question you must ask your doctor

June 23, 2014 Kevin 186
…

Tagged as: Primary Care

Post navigation

< Previous Post
What are some of the characteristics of healers?
Next Post >
The one question you must ask your doctor

ADVERTISEMENT

More by Richard Young, MD

  • When medical protocol meets family concerns

    Richard Young, MD
  • Patients in Sweden received fewer post-op opioids. Why is that?

    Richard Young, MD
  • Medicine is too complex for computers to keep up with or understand

    Richard Young, MD

More in Policy

  • How American medicine profits from despair

    Jenny Shields, PhD
  • What I learned about health care by watching who gets left behind

    Maanyata Mantri
  • How the One Big Beautiful Bill could reshape your medical career

    Kara Pepper, MD
  • Why the U.S. Preventive Services Task Force is essential to saving lives

    J. Leonard Lichtenfeld, MD
  • Brooklyn hepatitis C cluster reveals hidden dangers in outpatient clinics

    Don Weiss, MD, MPH
  • Why nearly 800 U.S. hospitals are at risk of shutting down

    Harry Severance, MD
  • Most Popular

  • Past Week

    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why GLP‑1 drugs should be covered beyond weight loss

      Rodney Lenfant | Conditions
    • How drug companies profit by inventing diseases

      Martha Rosenberg | Meds
    • How value-based care reshapes kidney disease management for better outcomes [PODCAST]

      The Podcast by KevinMD | Podcast
    • Imagining a career path beyond medicine and its impact

      Hunter Delmoe | Education
    • What is professional identity formation in medicine?

      Adrian Reynolds, PhD | Education
    • A step‑by‑step guide to crafting meaningful research questions

      Julian Gendreau, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why GLP‑1 drugs should be covered beyond weight loss

      Rodney Lenfant | Conditions
    • How drug companies profit by inventing diseases

      Martha Rosenberg | Meds
    • How value-based care reshapes kidney disease management for better outcomes [PODCAST]

      The Podcast by KevinMD | Podcast
    • Imagining a career path beyond medicine and its impact

      Hunter Delmoe | Education
    • What is professional identity formation in medicine?

      Adrian Reynolds, PhD | Education
    • A step‑by‑step guide to crafting meaningful research questions

      Julian Gendreau, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The payment bigotry against primary care doctors
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...