I’ve written that it is critical to examine one’s business environment often. To insure that what we are doing will make sense- and money- inf the future. Most of us lack lobbyists at our beck and call to insure our business is not overcome by those changes.

For years, physicians have been able to do just that. Oh, I’m not saying that they managed to stop the world- but they certainly kept it from changing their world too much. They opposed Medicare – vehemently- but President Johnson and Congress worked together to make that program law. Doctors opposed Obamacare (the 2010 Affordable Care Act or PPACA are the more correct terms)- but that is also the law of the land. And, this will also change their business models- in a very big way.  And, as I’ve reported, physicians were able to stop us from finding out just how much money they were making from Medicare, as well.

Obamacare is one reason why physicians are joining Accountable Care Organizations (ACO). It’s why hospitals- and insurance companies- are buying physician practices to incorporate these doctors into these ACO. So, it’s useful to see where our medical professionals stand right now.

Medscape has been surveying MD’s (Medical Doctors) and DO’s (Osteopaths) for years. This year’s results are especially interesting- because it’s the year after small changes due to Obamacare were instituted and the bigger changes in the offing are becoming clear.

Of the professionals surveyed, only about 1/2 would choose to become physicians again, given the choice. (It is useful to recognize that 50% of those surveyed were 50 years old or older.) Only 41% would choose to perform in the same specialty.

And, 52% felt they were underpaid. Of course, we should not overreact to this particular sentiment. After all, that’s about the same sentiment that all employees in America voice. (Business executives do not seem to have been surveyed- but since they are making 200 to 600 times what their average employees make, I don’t think they will say they are underpaid.)

Not surprising, orthopedic surgeons are among the highest paid of all specialties within the  medical field, averaging $ 405K, which is an increase of more than a quarter from the previous year’s compensation. (Note: This is for the physician practices alone. As most of you know, since all the newspapers seemed to have covered the practices of colonoscopic clinical centers, those that operate clinics make outrageous compensation.) The lowest paid professionals were HIV specialists ($ 170K), pediatricians ($ 173K) and family practice professionals ($ 175K). By the way, this is one of the reasons why there is a severe family practice professional shortage- one that may become acute in the very near future.

Interestingly, the highest paid physicians were NOT in the Northeast or California as one would normally assume; those in North Central (the Dakotas, Iowa, Arkansas, Nebraska, and Oklahoma) average $ 259K in compensation. The next highest paid region was the Rust Belt (Minnesota, Michigan, Wisconsin, Ohio, Indiana, and Illinois), $ 248K. The lowest paid regions were the Northeast ($ 228K) and the MidAtlantic ($ 232K).

55% of the physicians saw between 25 and 99 patients a week. And, about 2/3 of the physicians did this in under 45 hours a week (52% averaged 40 hours or fewer). [Please note that there still is paperwork – or computer work- to be done; 46% finished that task in 9 hours or less, with an additional 1/4 of all physicians spending 10 to 14 hours on paperwork.] Given these numbers, we can understand that 20% of the physicians spent about 10 minutes with each patient, 30% spent about 15 minutes, and 21% more with up to 20 minutes. (5% spent fewer than 9 minutes with each patient.)

As of now, 9% of the respondents stated that they are considering to refuse accepting new Medicare/Medicaid patients in their practice. 2% more are actually dropping those patients from their census. The overwhelming rest are staying with the status quo.  Except, from a different source, we are finding that while the numbers overall do not indicate the mass exodus from Medicare- the family practitioner (primary care physician) seems to be leaving in droves.  (So 9% of all docs is one thing, 20% of family practice not accepting Medicare is a whole ‘nother thing completely.)

We- and our doctors- are in for some interesting times!

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