Small Business: Doctors going broke

[Tuesday Afternoon]

By Parija Kavilanz | CNNMoney.com

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


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.

more at link:
http://finance.yahoo.com/news/small-business-doctors-going-broke-101200127.html

[Ruby the Liberal]

1. Tell me again why single payer was off the table

before the talks even started?

From your link:

"I recently got a call from a divorced woman with two kids who is unemployed, house in foreclosure with advanced breast cancer," he said. "The moment has come to this that you now say, 'sorry, we don't have the capacity to care for you.' "

[Tuesday Afternoon]

2. beats me.

thing is most of the Doctors that I personally know are a lot more liberal and acceptive of the idea of Single Payer than the Pharmicists I know, who are very conservative. I realize this anecdotal evidence only but, it is my personal experience and it makes me wonder.

[Yo_Mama]

3. Doctors are facing bad choices about not treating patients who need to be treated.

They just want this current situation to end.

Pharmacists are already dealing with government insurance programs that don't even reimburse for cost - they are terrified that single-payer will utterly destroy the industry. From their perspective the government isn't making good choices.

There are growing generic drug shortages mostly related to low payments for drugs, which is occurring globally.

[Ruby the Liberal]

5. And compounding that, they raised the time window for patents

in order to 'incent' R&D.

Lotsa crazy stuff in that bill when you really start digging around.

[Ruby the Liberal]

4. That has been my experience as well

At least in the practice that serves as my PCP.

My Doc told me during the debate (2009?) that if they just dance around the edges, they are going to blow things up worse than they are already. Strong stance, but when you take into account the actual authors of the Baucus bill (Insurance and Pharma), I can see his point.

[Warpy]

6. Right, and the new docs average a quarter of a million of debt

by the time they get out of med school. They can't treat people for chickens and house cleaning, they have to get real money to pay that debt down.

Docs have been my best allies in coping with 26 years of being uninsurable, cutting their fees, downcoding, and finding the cheapest generic drugs if they don't have samples in stock.

However, we're heading to a real crisis as people get sicker and sicker because they've been underemployed and have no insurance, doctors are finding themselves with fewer patients to pay their bills, and student loan debt prevents them from dropping their fees to encourage sick people to seek treatment.

This system couldn't be any more cruel to all of us if Dick Cheney and David Koch had designed it from the ground up.

[Ruby the Liberal]

7. And malpractice premiums are out of control.

Our main ObGyn office closed a few years ago because of how out of control it got.

That said, there is another good point in this article and that comes from the 'running a business' perspective. I love my Doc and he does go the extra mile for me with samples and alternate options in trying to give the best care for the most affordable option. That said, he isn't a business man. I have never been in a capacity to advise him or his partners, but have many others. The thing I saw about doctors on this is that they are highly educated, and as such don't like dealing with things they find complex or otherwise don't understand like highly tuned cash management/flow best practices or intricate lease terms.

I am in no way suggesting that they (broad brush) aren't capable of understanding, only that they are amongst the busiest people I have met (keeping up with the latest constantly) and if something doesn't seem to click immediately or come naturally, the tendency is inaction.

Unfortunately, this isn't a perfect world, and a medical practice IS a small business. Just because they are a highly trained medical group doesn't exempt them from making the same necessary business decisions as the HVAC down the street.

[jwirr]

8. My guess is that you hit the biggest reason.