Doctors in America are going broke? YES.

[mjp28]

Small Business: Doctors going broke
By Parija Kavilanz | CNNMoney.com

Doctors in America are harboring an embarrassing secret: Many of them are going broke.

http://finance.yahoo.com/news/small-...101200127.html

[NOTE: I've done taxes for years, some investing and finance, this has been a growing problem for years! Is your doctor save?]

This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.

Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.

"A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame.

Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. "And we still barely made payroll last paycheck," he said. "Many of us are also skimping on our own pay."

Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. "Our total revenue was down about 9% last year compared to 2010," he said.

"These cuts have destabilized private cardiology practices," he said. "A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well."

Pentz is thinking about an out. "If this continues, I might seriously consider leaving medicine," he said. "I can't keep working this way."

Also on his mind, the impending 27.4% Medicare pay cut for doctors. "If that goes through, it will put us under," he said..........CONTINUED.......good read!

[mjp28]

I remember about 10+ years ago talking with a friend of mine who also has an MBA who sold investments and insurance telling my how bad a credit risk some doctors were getting to be.

The bad thing now is some small towns and hospitals and clinics are going to be even worse off for medical care.

I've heard of some doctors actually going into law....probably to work for insurance companies and big pharma!

[gun runner]

There is always going to be a need for doctors, so if things get tough for these pigs they will just suck more money out the insurance companies. I believe Obama needs a psychiatrist teehee

[Vladimir]

I honestly think this is some natural leveling off. Doctors are one of those areas that saw such a boom they way overspent. It's like the dentist, same crap. Most dentists now you don't even have to leave the chair for your x-rays. Ridiculous waste of money. Same story with doctors. Things were good, they bought stuff they could not really afford, and now someone has come knocking at their door asking for the money they owe.

Story of everyone who is in a bad position right now. You are in a bad position for one of two reasons. You made bad financial decisions, or you worked for/relied on someone who made bad financial decisions.

[mjp28]

Another thing, new doctors 4 years undergrad, 4 years med school and internship plus all the tuition, student loans the come out broke and in debt.

$50,000? $100,000? $200,000? Not good.

[Vladimir]

Originally Posted by mjp28

Another thing, new doctors 4 years undergrad, 4 years med school and internship plus all the tuition, student loans the come out broke and in debt.

$50,000? $100,000? $200,000? Not good.

Why? They will come out of school making over $100k a year probably.

[redwing carson]

What is $200,000 to these guys? Have you had a real illness lately? That is 2 office calls.

[gad1111]

I've got to think the cost of malpractice insurance has a lot to do with this, i heard a while back dr.s pay about 2/3 of their income for insurance, not sure how true it is but I would believe it with the way people sue at the drop of a hat.

[jack404]

it's about $140,000 a year for a surgeon, and 200 K for a baby doctor, folks sue over babies often , premi ones especially i read last year why so many doc's in the US have come to Oz , here its capped at 1/3 rd of their income but our claims system here is also capped...

[Deacon_Man]

Here in Texas now medical malpractice claims are caped at $250,000.00. Your Lawyer gets 40% of your judgement. Also if you sue and lose the case you are now required to pay all court cost and Lawyers fees for both parties involved.

[raven818]

This year brings another 27% cut in medicare payments. My, many years, doctor is a close friend. She told me at my last visit, last month, that the new cut may put her out of business. Yes, they spend huge money on equipment. Would you rather see a doctor who guesses what's wrong with you? Not me. Her huge clientele, like most in private practice, is dedicated to medicare patients, which account for 50% of her practice.

And that 50% is going to rise dramatically, very soon. The country is growing old, fast. Specialists only, make the huge bucks.

When a non-specialized doctor graduates from school, they are on a starvation diet until they get their practice well established. And that takes years.

[gun runner]

Originally Posted by raven818

This year brings another 27% cut in medicare payments. My, many years, doctor is a close friend. She told me at my last visit, last month, that the new cut may put her out of business. Yes, they spend huge money on equipment. Would you rather see a doctor who guesses what's wrong with you? Not me. Her huge clientele, like most in private practice, is dedicated to medicare patients, which account for 50% of her practice.

And that 50% is going to rise dramatically, very soon. The country is growing old, fast. Specialists only, make the huge bucks.

When a non-specialized doctor graduates from school, they are on a starvation diet until they get their practice well established. And that takes years.

Or if not they can go work for a hospital or clinic etc until they get more experience but your right. If I was going through this I would go with start my private practice right away to get reputable.

[The Duke]

Amen, Raven...Cut assistance (medicare) for those who will need it the most...Join Obambo Care and every thing will be fine...What a Slick and Sick Bastard he is..

Ive a friend who retired his OB/GYN practice early because his malpractice insurance was costing $100K a year!!! AND he had never been sued...

Unfortunatly for us, it will turn the doctors into pill pushers...treat'em and street'em...No time for a real diagnosis, get'em in, give'em an Rx and out the door so they can get to another patient...A good 10-12 years schooling for a GP, lotsa money spent for tuition and such ... For what they have to go through to become an M.D. and the hours spent making rounds at the hospital(s) and being on call, they are worth every dollar they can make....

[mjp28]

Originally Posted by Vladimir

Why? They will come out of school making over $100k a year probably.

Not really, the 1950-1980s "golden years" are pretty much gone. Most come out as specialists or join a group in practice. Malpractice insurance alone can run $2000/mo (+/-) or much more...that's $25,000+ per year, whoa.

My wife's worked in a hospital for ~36 years, the last 23 part-time it used to be nice, it's hell now. In 1970 there were about 3% indigent patients now it can go 35, 45, 55% or more with no insurance. Plus insurance companies, big pharma, Medicare, Medicaid are all tightening up.

About 50,000,000 Americans have none, so who pays for them?

I know a lot of doctors young and old it's not fun anymore.
------------------------------------------
Now let's talk about lawyers.
I know some right out of law school making ~$22,000/yr.....maybe.

[redwing carson]

The AMA to which these doctors belong is the most antigun group in the country. I can not grive for these guys. They always have enough left over to pump millions in to the Ban all guns movement.

[The Duke]

MJP28 is right...I worked ER as an RN for about 15 years after retirement...When I first started, I could have worked acute care (ICU, ER) in Houston on the weekends and made as much per hour as the ER MD were making at my hospital.....

[mjp28]

Originally Posted by The Duke

MJP28 is right...I worked ER as an RN for about 15 years after retirement...When I first started, I could have worked acute care (ICU, ER) in Houston on the weekends and made as much per hour as the ER MD were making at my hospital.....

Yes and malpractice insurance can vary "wildly" between location and speciality.
Internal MD from $15,000 to $40,000 all are (+/-)
Surgeon $30,000 to $75,000
OB/GYN $50,000 to $200,000 or more.

Then the new regulations, paperwork, HIPPA, staff, equipment (freebies are way down), on and on.

About 20 years ago my "old" MD (about 45 years old and burned out, went to work for an ER place for a salary) sold his practice to my new MD and a friend, since then they've moved twice reorganized several times. (I'll guess expenses, taxes, etc.)

So hello India, Pakastan, Korea, Phillipino et. al. med students, come to America!

[Gun Geezer]

I had both my hips replaced within the last 3 yrs. The first cost $75K and the second final bill ran $100K. The doc. who did me, only operated on Wed.'s when he had the hospital's entire operating room to himself. He does hips, knees and shoulders from 7AM to 7PM. The surgery takes between 2-2.5 hrs. Do the math. The other days of the week he does joint trauma surgery. Am I going to take up a collection for him, I think not!

[raven818]

Originally Posted by Gun Geezer

I had both my hips replaced within the last 3 yrs. The first cost $75K and the second final bill ran $100K. The doc. who did me, only operated on Wed.'s when he had the hospital's entire operating room to himself. He does hips, knees and shoulders from 7AM to 7PM. The surgery takes between 2-2.5 hrs. Do the math. The other days of the week he does joint trauma surgery. Am I going to take up a collection for him, I think not!

When you boil it down to all the costs involved--hospital--nurses--meds at hosp--anesthesiologist ( serious bucks )-- three shifts of other doctors doing follow up at hosp, etc. His personal take drops way down.

[mjp28]

Originally Posted by raven818

When you boil it down to all the costs involved--hospital--nurses--meds at hosp--anesthesiologist ( serious bucks )-- three shifts of other doctors doing follow up at hosp, etc. His personal take drops way down.

Right, they crank the total cost WAY up to try to cover everything.

Still I'd love to see the "real" books someday.

BTW the hospital my wife works at went Chapter 7 bankruptcy, got bought out, working short there is real hell, DON'T GET SICK!

Many have gone under, shut ERs, the system is screwed up!!

[Zhurh]

A hunting buddy back east is a dentist. He once told me he had to do like 30 thousand in dental work every month to just cover his overhead, rental equipment, college loans, office rent, and that sweet young starlet he had for a secretary. It was the secretary that got most of it I do believe, ha ha; what a looker. Anyway he also said there were too many dentists and the only ones really making it were the ones that ran from chair to chair.

Yet the same dentist would always be showing me new guns he had just bought right in his office; quite funny to see the looks on his other office appointments, ha ha. He was my kind of dentist too.

[mjp28]

Originally Posted by Zhurh

A hunting buddy back east is a dentist. He once told me he had to do like 30 thousand in dental work every month to just cover his overhead, rental equipment, college loans, office rent, and that sweet young starlet he had for a secretary. It was the secretary that got most of it I do believe, ha ha; what a looker. Anyway he also said there were too many dentists and the only ones really making it were the ones that ran from chair to chair.

Yet the same dentist would always be showing me new guns he had just bought right in his office; quite funny to see the looks on his other office appointments, ha ha. He was my kind of dentist too.

College loans (besides blonde secretaries) can be a killer, you can NOT bankrupt them away! They are on you like glue until you pay them off, some students go a bit wild in college and run them way up. Some do not understand bank and tax laws and refi themselves into more trouble. Plus tuitions are unreal.

Unless mommy & daddy pay the bill it can be steep. I worked my way through my undergrad....but it was $150 a quarter plus $5 parking -and- I had a good job. (And once I was in supervision my employer paid for my MBA, whew!)

SCREW THEM

GO see a Vet they are better docs anyways.

Think a Vet has to learn 10 times what a Human doc does in the same amount of time.

[reynolds357]

Originally Posted by redwing carson

What is $200,000 to these guys? Have you had a real illness lately? That is 2 office calls.

My best friend is a medical Doctor and he does not make real good at all. His practice turns about $150,000 a year profit for him, but that is before his medical malpractice insurance is paid. Last year, his premium was over $70K. He went to college 12 years to work 12 hours a day five days a week, 4 hours on Saturday, and make $80K per year?

[reynolds357]

Originally Posted by Gun Geezer

I had both my hips replaced within the last 3 yrs. The first cost $75K and the second final bill ran $100K. The doc. who did me, only operated on Wed.'s when he had the hospital's entire operating room to himself. He does hips, knees and shoulders from 7AM to 7PM. The surgery takes between 2-2.5 hrs. Do the math. The other days of the week he does joint trauma surgery. Am I going to take up a collection for him, I think not!

When I had my shoulder surgery, the Dr. and Hospital bill together were over $27,000. When the Insurance company actually adjusted the bill, the total the Dr. and hospital got was less than $5k. I think for what they did, the compensation they received was not that wonderful.