Want to know why big hospital systems are buying physician (particularly primary care physician) practices as fast as they can?  Open this link and scroll down to page 6.  Now before you get huffy about these “rich doctors” let me clarify what these numbers really mean.  These amounts represent revenue generated for the hospital system for which the employed doctor works, not what the physician is paid.  

Ordering lab and xrays and MRI’s and physical therapy and nutrition consults…that is the stuff these numbers are made of.  Charging for office visits (keep in mind that the great health cartel has decided to pay more for office visits for physicians employed by hospitals than for those same visits to private practitioners) and charging for visits to patients in the hospital make up part of this number, as well.  Let’s not forget referrals to specialists and the money that generates as part of the plan.

This is a perfect time to reconsider some of the advantages EMR (electronic medical records) provides to the hospitals:  

the ability to automate physician ordering, and

the ability to “cut and paste” complicated physician visits from one day to the next, making it appear the patient is receiving more intensive treatment and attention than the thick and incomprehensible medical record indicates.

Automated ordering means that when a patient is admitted to the hospital, certain billable events are initiated whether the physician believes these to be appropriate or not.  Nutrition consultation, laboratory specimens, you name it.  An employed physician who complains about “his” patients receiving unnecessary nutrition consultations risks the wrath of those directing these revenue-generating activities:  his bosses.  

Back to page 6 of the link.  Let’s say a family practitioner in private practice in a small town is making about $180,000 per year, working like a madman to generate this sum.  A hospital administrator or recruiter from the big city offers this doctor, $375,000, promising to take on the headaches of malpractice insurance, government and insurance regulation compliance and employee management.  In return, the doctor sends all of “his” patients to the big city hospital for testing and specialty referrals.  This doctor signs on and his “production” for the mother ship is closely tracked.

The small hospital to which this doctor used to send his patients is devastated by this new arrangement, rendering this small facility susceptible to “an offer” from the big city hospital.

This is not the free market.  This is a syndicate, the result of which is outrageous pricing and poor quality.  The cause is the intrusion of the government into this industry, politicians having accepted countless bribes over the years to provide their hospital and insurance pals with this type of leverage.  Obamacare represents this syndicated arrangement on steroids, while its proponents have duplicitously sold it as beneficial to the poor and uninsured.

Those of you reading this, who see a doctor who works for a hospital, now know not only the game, but the numbers.  Keep in mind that your doctor must “generate” these numbers by “caring” for you, or, not having earned his/her keep, they are history.  When your employed doctor tells you that you need a test or an MRI or some such, consider asking them,” Is that what I need or is that what you need for me to need?”

G. Keith Smith, M.D.

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