The CMS is thatÂ department of the federal government that determines what services will be allowed and how much your physician will be reimbursed when those servicesÂ are provided. That department is unfortunately highly influenced by the medical specialties that are procedurally oriented. This leads to some significant problems in the healthcare industry. Simply put, those medical specialties that tend to do more surgeries and procedures get paid far more than those that don’t. For example, a General Surgeon, Ob/Gyn, or a UrologistÂ will make a lot more money than those in primary care such as an Internal Medicine, Family Medicine or Pediatric physician. Society will need to make a decision whether that is proper or not based upon the final outcomes. One of the results, is that very few of our new physicians will be choosing to practice primary care. Why spend half-an-hour seeing a patient for their diabetes, hypertension, and reflux disease for $115.00 when you can see a patient for a quick procedure in the office and get paid $680.00? One of my medical partners recently saw a patient for just the above. The patient complained that the charge for his primary care issues was $117.50 while the charge for freezing off a small lesion that took 2 minutes was $286.00. Exactly!!! When physicians subsequently choose to avoid the primary care fields of practice, no one gets seen for routine medical care. Who does more good for the overall population? Is it those who see people for primary medical issues such as diabetes, hypertension, reflux disease, childhood care and immunizations or a Urologist who cares for the prostate of an elderly man? Society needs to decide and decide quickly because it takes at least 11 years to produce a physician.
About Richard Edgerly, MD
I am a board-certified (not that it matters), Family Medicine physician who practices in rural Washington State. I am the owner of Assurance Healthcare and Counseling Center in the city of Yakima.
Always appreciating what a little humor does to refresh the soul, I have also written a collection of stories about events that have occurred over the years in my practice, and I hope that they will also make you laugh (see Just a Spoonful of Laughter Helps the Medicine Go Down).