Monday, April 24, 2006

Short Doctors

After reading your recent article that discussed the shortage of doctors along the border, I have some thoughts I wish to express.

A large portion of the population in this area receives their medical coverage through Medicaid. Medicaid pays $29 for an average office visit. Most other insurances pay approximately $60 or more.

It should be noted that Medicare uses the same fee/reimbursement schedule as Medicaid. The issues raised in this article are not just limited to border towns, nor are they limited to Medicaid patients.

Also, other insurances [sic] will cover tests and services that the patient might need during their visit, whereas Medicaid does not allow for them or pays at a very discounted rate, to the point that one might actually lose money by providing the service.

How would you feel about being treated by a doctor that is losing money on your care?

Because of this, it takes at least two to three Medicaid patients to equal the revenue generated by one non-Medicaid insured patient.

By most medical personnel about the United States, a normal doctor load is approximately 30 patients per day.

In my practice, and I believe in many other practices in the area, 90 percent of the clientele is Medicaid. Therefore, in order to generate the income of a normal patient load elsewhere, we have to see double. In other words I have to see 60 patients to make the income of 30 patients.

Not only is the reimbursement to the doctor much lower, but the doctor must work twice as long to make the same money. This does not generate a warm feeling knowing I might be patient number 60 for the day.

As long as many doctors feel that to work in the border area they will have to see twice as many patients to generate an income equivalent to 30 patients elsewhere, the border will continue to have a doctor shortage.
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