Re: No Guts Not Glory, was Re: Open Mind, Brains Fell Out (was Re:
From: jkulkin (jkulkin@mindspring.com)
Sat Apr 21 16:34:53 2001
It is expenisve to run a practice. Economies of scale are a wonderful
thing.
JK
"D. Ashley Hill, MD" wrote:
> At Sat, 21 Apr 2001, Eberhard Lisse wrote:
>
> >But to argue about semantics, when we all know it is for pecuniary
> >reasons (whether you call it rescheduling of office appointments,
> >stock options, Porsches or Country Club memberships) is sick.
>
> El-
>
> The ACOG bulletin does not affect me, as I take in-house call. It can
> have a large effect on solo doctors. You should not assume that because
> some are complaining about the requirement to be "immediately available"
> that they are complaining about decreased personal income. It takes a
> lot of money to run a medical practice (in the US, overhead for an
> ob/gyn practice typically runs about 50-55%).
>
> Geff spelled it out quite clearly: the overhead costs for the doctor who
> is sitting in the hospital lounge continue to accumulate. The office
> staff, nurses, insurance billers, collections staff, power company,
> office supply vendors, and malpractice insurance company all want their
> money. (Malpractice insurance costs each of my partners and I about
> $86,000 per year). If the doctor cares for a number of VBAC patients
> and sits in the hospital "immediately available" many times a month,
> then he or she may not be able to afford to keep the practice running,
> or may need to cut office staff. Further, the doctor's other patients
> are not receiving important care they need while their doctor is waiting
> in-house. Even if the doctor takes home less money, it might not offset
> the expenses of providing VBAC services. Of course, rather than provide
> substandard care, ob/gyns in small practices who cannot afford to remain
> in-house over lengthy time periods, many times a month, will have to
> decline offering a trial of labor to patients. (The needs of the many
> outweigh the needs of a few). Those patients can transfer to another
> physician with more resources, or to a larger group.
>
> Ashley
>
> --
> D. Ashley Hill, MD
> Associate Director
> Department of Obstetrics and Gynecology
> Florida Hospital Family Practice Residency
> Orlando, Florida
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