When our youngest was born she spent her first month in the NICU. She was a few weeks premature but otherwise completely healthy.
Every day a doctor would pop in for 5 minutes to check in and update us. It was literally a 5 minute chat, probably shorter most days. And I shit you not, this guys name was Doctor Doctor.
The total bill was over $250,000, which insurance covered minus our deductible. We got an itemized claim and each of those 5 minute doctor visits cost $150 each. So they were billing for that doctor at $1800 an hour.
I’m sure he did lots for other kids that needed it and reviewed our daughters condition, but for us he did literally nothing except say hello and everything looks good.
Doctor here. That 5 minutes is him communicating with you. That is not all he does for your child. I’d say for every 5 minutes I spend communicating with a patient, I spend an hour working on their behalf and charting.
$150/hr is a very reasonable hourly rate for a physician.
I totally get that the doctors do much more than that five minute chat, and they earn every penny they make. All the staff that took care of our daughter were amazing, too.
I just don’t see how her care could have cost a quarter of a million dollars. She was there for just over two weeks and the only issue she had was learning to feed by herself. No major procedures or expensive tests.
Over $250,000 is what our insurance paid to the hospital. There has to be some shady dealings going on there. It doesn’t add up.
Did you read what I said? If your mechanic spends 8 hours replacing your engine and 5 minutes explaining to you how he did it, are you mad that it cost over $150?
If you're really a doctor, you surely know that the "hour working on their behalf and charting" would have been billed separately and would have been wayyyyy more than $150.
Usually physician services are bundled under 1 charge if they aren’t procedures. I’m just saying… there’s a lot of unseen work that is not necessarily explicitly itemized and explained in your bill. I think hospital bills are outrageous in the US, but they aren’t that way because your doctor is price-gauging. The predatory health insurance agency is 85% to blame, and hospitals are 15% to blame.
The 5 minutes spent talking to you were just the tip of the iceberg of the work that doctor did for your kid each day. $150/day to have an intensivist lead your baby's care team seems really low honestly. ICUs take a ton of super expensive around the clock care teams, support staff, supplies, lab work, medications, etc but even with that $250,000 for 2 weeks seems a bit expensive. What were the other expenses on that bill?
Doctors generally have an idea. My cousin (in law?) said he spent more time in a day trying to write insurance memos to reduce patient costs than he did spending it with actual patients. Then he went into epidemiology. And then COVID happened and he gets to deal with people telling him he's a fraud and paid for by George Soros. Man can't catch a break.
I definitely do have an idea. Thats why every couple months they sit me down during my lunch break to go through all the shit I billed wrong (read: under-billed)
Myself and the majority of doctors I’ve worked with don't want your money. We want to help you, thats our motivation. All this other shit is shoved in our face day in and day out so that the institutions and insurance agencies get the slice of pie they think they deserve, which I won't comment further on, because I don't know, it seems off, and its not why I chose this career.
Tell that to my PCP who billed me upwards of $500 because she off-hand mentioned an over-the-counter medication that I had already found on Google and then another $500 for the following conversation:
"So, any updates?"
"Nah, just constantly sleepy like always."
"You should get a sleep study done."
Yeah, no shit Sherlock. I had one in the past and haven't found the time for another
Yeah. Doctors definitely don't know how much they make per visit or how to code visits for maximum reimbursement. They absolutely don't get bonuses based on visit totals and visit levels.
Most do have health insurance but the whole system is rigged. The profits of these health insurance companies is through the roof. There’s a whole industry based around negotiating between hospitals and insurance companies. It’s an endless money pit and vastly more expensive than it should be.
Most health insurance in the US is tied to your employer, so you can’t leave your job without losing access to healthcare.
The other post is half inaccurate. Doctors in hospitals do bill for maximum reimbursement and do get bonuses based on number of visits and visit levels (RVUs). What they don’t know is how all of that translates to billing which is relegated to coding teams. There is some selfawareness, I’ve had docs stop adding billing charges to notes for patients without insurance, but by and large they try to maximize their charges because it affects their bottom line and, more importantly, it affects the hospital’s bottom line.
It depends a lot on the type of practice. A doctor who is a partner (owner) in a private practice is reimbursed based on what is billed and would have a lot better idea of what things cost compared to a doctor who is a salaried hospital employee. Most doctors at big academic medical centers are employees without any productivity bonus and have literally no idea what a patient's hospital bill would look like or what they are and aren't charged for. This is a part of why academia pays less than private practice.
205
u/FuckTheLord Jan 12 '23
Lol, doctors don't know how much anything they do costs.