Call Me Naive....I Didn't Know That Doctors Were in the Business of "selling" Drugs

[Nwit]

This blog post was very "chilling" to me...makes me wonder what else I don't know about our health system.

Health Beat: A Very Open Letter from an Oncologist

After it opens scroll to the top.....

I urge you to take the time to read this lengthy post...

 

[Todd King]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

I'm not convinced that all doctors make money selling drugs. In the particular article the doctor was talking about administering chemo. That is actually done in house, not something that the patient goes to the drug store to buy.
Nevertheless though, it still makes one wonder what we don't know.

 

[retread]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

I'm not convinced that all doctors make money selling drugs. In the particular article the doctor was talking about administering chemo. That is actually done in house, not something that the patient goes to the drug store to buy.
Nevertheless though, it still makes one wonder what we don't know.

It is eye-opening to know what factor Part B drugs play in a Medicare contracted doctor's practice in oncology is.

Don't miss the Medicare reimbursement for billable time, either: 15 min = $69. So a beneficiary paying a $30 copay is paying almost half the office visit expense? Is this in addition to Medicare re-imbursement? I think so.

I don't know when they start the clock, but I hardly get more than 5 minutes with the doc, however the nurse takes my BP, pulse, weight, ht, etc. which takes another 5 minutes. Then I sit alone in the exam room for at least 5 minutes. That adds up to 15!

So, IF you were to get 15 minutes with the doc, he would see perhaps 32 patients a day (8 hrs) and gross $2208/day. That's $8832/wk (docs play golf at least one day, so only work 4 days a week), or $35,328 a month or $388,608/yr. (11 months, one month vacation). This is just at the Medicare rate... I would assume he gets more from non-Medicare patients. And for the Medicare Advantage patient add the copay... say 30% of his patient load is Medicare, and the extra $30 per visit at (5632 x 30%=1690 Medicare visits @$30= $60,700) brings his annual income to $449,308! And this is not counting the income from Part B drugs....

In actuality, he can see more than 32 patients in an 8 hr day if he stacks them up in a waiting room and makes everyone wait in separate rooms while he scurries between each patient.... wait a minute! Everybody knows this is how it is done!!!

Annual income of almost 1/2 mil is reasonable to expect. Yes, office staff has to be paid, etc., but just add a couple more doctors to the practice to share the expenses.....

 

[dgoldenz]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

It is eye-opening to know what factor Part B drugs play in a Medicare contracted doctor's practice in oncology is.

Don't miss the Medicare reimbursement for billable time, either: 15 min = $69. So a beneficiary paying a $30 copay is paying almost half the office visit expense? Is this in addition to Medicare re-imbursement? I think so.

I don't know when they start the clock, but I hardly get more than 5 minutes with the doc, however the nurse takes my BP, pulse, weight, ht, etc. which takes another 5 minutes. Then I sit alone in the exam room for at least 5 minutes. That adds up to 15!

So, IF you were to get 15 minutes with the doc, he would see perhaps 32 patients a day (8 hrs) and gross $2208/day. That's $8832/wk (docs play golf at least one day, so only work 4 days a week), or $35,328 a month or $388,608/yr. (11 months, one month vacation). This is just at the Medicare rate... I would assume he gets more from non-Medicare patients. And for the Medicare Advantage patient add the copay... say 30% of his patient load is Medicare, and the extra $30 per visit at (5632 x 30%=1690 Medicare visits @$30= $60,700) brings his annual income to $449,308! And this is not counting the income from Part B drugs....

In actuality, he can see more than 32 patients in an 8 hr day if he stacks them up in a waiting room and makes everyone wait in separate rooms while he scurries between each patient.... wait a minute! Everybody knows this is how it is done!!!

Annual income of almost 1/2 mil is reasonable to expect. Yes, office staff has to be paid, etc., but just add a couple more doctors to the practice to share the expenses.....

I would tend to think that malpractice insurance alone would eat into a substantial portion of that half million dollars. There is no way a doctor grossing $500k before expenses could stay afloat and still pay all of their overhead and employee costs.

 

[retread]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

I would tend to think that malpractice insurance alone would eat into a substantial portion of that half million dollars. There is no way a doctor grossing $500k before expenses could stay afloat and still pay all of their overhead and employee costs.

That's a big assumption.

 

[dgoldenz]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

That's a big assumption.

I am not an expert, but from what I have read in the past the premiums can be upwards of $200k/year even for a small practice. I'd say that's pretty substantial.

 

[Ron Van D]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

One of my clients in an OB/GYN in Indianapolis and his malpractice insurance is about $45,000. He told me if he practiced in Chicago it would be triple that (or more).

 

[Nwit]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

So this is ok.....????

"Treating patients with a 2 hour infusion of pamidronate (a generic drug used to treat cancer that has spread to the bone) rather than a 15 minute infusion of Zometa, because one could make $500 more on the generic pamidronate."

If you were given a choice of spending 15 minutes or 2 hours for a treatment, which would you choose?

The doctor makes $500 more by putting the patient through a 2 hour procedure. Is that ethical? The doctor chooses the longer procedure in order to make more money.

Would that happen if the doctor did not sell the drugs himself? If he wrote a prescription, you picked up the drug from the drug store and brought it to the office, which drug would the doctor prescribe? Chances are he would choose the one that only required 15 minutes to administer.

It's the ability of the Doctor to "sell" these drugs that allows this abuse.

 

[Crabcake Johnny]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

When you start to get into expensive treatment you'll find yourself in case management.

This is when the carrier steps in and possibly declines payment for the more expensive treatment.

 

[Nwit]

Re: Call Me Naive....I Didn't Know That Doctors Were in the Buisness of "selling" Dru

Thanks for the replies but no one has addressed my central question. Should a doctor be in the business of selling drugs and the temptations that come with that activity?