Where physicians are losing money

Four physician leaders connected with Becker's to discuss where physicians are losing money right now. 

Editor's note: These responses were edited lightly for brevity and clarity.

Cary Passik, MD. Cardiac Surgeon at Good Samaritan Hospital (Suffern, N.Y.). Physicians are now and have been in recent years losing money on fair and reasonable fees for their procedures. This is an unavoidable side effect of the destruction of real market forces. In America, there are fair and reasonable prices for almost anything. That may be a car or a used hard drive on eBay. It no longer applies to physician services, in my opinion. The reimbursement for coronary artery bypass, the most common procedure that I perform, is now less than 1/3 of what it was when I first started in practice in 1988. And that is in 2023 dollars! When the reimbursement for coronary bypass (a routine but very complex procedure), which includes 90 days of global care, has become 1/10 of what it would cost to get your bathroom remodeled, there is something wrong with the system. I think we need to sit down in the room each year with insurance companies and the state and federal governments and come up with reasonable and fair fees for everything that we do. 

Darley Solomon, MD. General Surgeon at the Doctor's Hospital (Cayman Islands): Although I am an employee and no longer involved with the day-to-day challenge of billing and collecting, I anticipate that things have not gotten any better in terms of billing, collections, denials and reimbursements. With current inflation and prices increasing, it is no doubt a challenge to continue providing care in the face of decreasing reimbursement.

Leonid Pravoverov, MD. Nephrology Specialist at Oakland (Calif.) Medical Center. Dealing with insurance preauthorizations, electronic medical records and related 'desktop' medicine demands — secure messages, forms, best practice alerts, coverage for colleagues in practice, etc.

Vlad Frenk, MD. Anesthesiologist at Integrated Anesthesia Associates (Shelton, Conn.): Private equity deals are mostly money losers in the long run. Short-term gains for a selected few members translate into inability to recruit and retain young talent or stay lean and efficient.

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