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

  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Choosing between care and country: a dual citizen’s Independence Day reflection

    Kathleen Muldoon, PhD
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions

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

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions

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...