The Rule of Twenties

Heard from a local independent gerontologist tonight who does not accept Medicare or other insurance payments in our state:

"When it comes to geriatrics, it's the rule of twenties:

20 problems
20 medications
20-minute phone calls
20 minutes to take their clothes off
20 minutes to put their clothes back on.

With the initial physical exam, three follow-up visits, and one EKG that Medicare pays for, I would receive only $360 in total. I pay $40,000 per year in malpractice, yet have never had a judgement against me. Think how may patients I'd have to see to cover just that expense. (editor's answer: 111)

You wonder why I am not a Medicare provider? I'd never survive at that their payment rate. And Blue Cross? They're no better and often pay less.

Funny thing is, Medicare was only too happy to have me opt out, because to them, I'm no longer part of their problem."

And the reason every primary care doctor's not doing this???...

-Wes

The New American Medical School Challenge

Nature abhors a vacuum.

And no where is this more clear than residency slots in Internal Medicine.

Today, I learned some interesting statistics that should alert medical students applying to residency programs across the country.

1. Surprisingly, applicants to our categorical residency program is up 15% this year.


2. The number of foreign medical graduate students to this year's applicant pool has increased 50% over last year.

In short, the medical marketplace for doctors is becoming a global one, and the need to support current salary levels is likely to erode in the not-so-distant future.

-Wes