Letter to the editor: Payment outlook for docs worse than 'cloudy'

A reader writes that it is nearly impossible under current reimbursement rates to maintain an independent medical practice.

Assuming the reimbursement numbers you listed in your article, ‘The payment outlook for 2014: cloudy” (January 10, 2014)  are correc,t (I suspect these are RVU rates paid to employed physicians) it is not hard to see why the future of the independent primary care physician is at best cloudy.

When I was economically forced to leave my solo practice my overhead was about $150/hour. If one does the math using your reimbursement figures, in order for a doc to earn $150,000 a year, he would have to see a 99213 patient in less than 10 minutes. Those figures are generated with some unlikely assumptions; that the doctor has 40 hours per week of patient-booked hours, that he works 48 weeks per year, and that every appointment is filled.

When I left solo practice I was being paid $52 for an office visit while the large, multi-specialty group down the street was being paid $95 for the same visit. The insurance company had no interest in improving my position and organized medicine threw up their hands and said there was nothing they could do.

If our government and the public believe that the best and brightest will go to school until after their 30th birthday and incur hundreds of thousands of dollars of debt in order to make less than most public safety officers, they will be sadly mistaken. I’m afraid that 'cloudy' is being optimistic.


Steve Howard, MD

Belmont, California