From: The Watcher’s Council
The Council has spoken, the votes have been cast and the results are in for this week, carved eternally in the Akashic records of cyberspace.
One thing we’ve always taken for granted here in America is the availability of doctors and being able to see them in a timely manner. As this week’s thought provoking winner, Working for Free: The Economics of Being a Primary Care Physician by The Razor reveals, if present trends continue, that may be a thing of the past – especially if ObamaCare isn’t repealed. Here’s a slice:
Assume a business day of 8 hours. For each hour a family/primary care physician can see 3 patients at 20 minutes each. During each 20 minute visit a doctor has to review a patient’s history, listen to the patient’s complaint or reason for the visit, make a clinical diagnosis on how to best treat the patient’s problem, and assess the patient for signs of any other disease process. All this must be carefully notated in the patient’s chart to track progress and to document the visit for insurance purposes and in rare cases, legal actions.
So the doctor sees 24 patient’s in a day. Assume each patient’s insurance is billed $100 for the visit. Of that $100 the doctor’s practice expects to receive (including patient co-pays) $50. 50% of that $50 is kept by the practice to pay for overhead (medical assistants, receptionists, nurse practitioners, building costs etc). That leaves the doctor $25 per patient.
3 patients an hour means $75 hour, and that equals at 2000 hours a year, $150,000. This is a good wage by most standards. The problem is that doctors don’t work 2000 hours.
As well as seeing 24 patients, the doctor is responsible for managing physician assistants and nurse practitioners. He or she is ultimately responsible for the treatments made by these mid-levels and can be held accountable by the medical board and in court for any mistakes they make. This usually means monitoring what the mid-levels are doing, reviewing their charts, and assisting with their treatment options. This supervision is completely unpaid; the doctor is not reimbursed for his or her time.
Throughout the day test and lab results from current patients arrive on the doctor’s desk. S/he must review these and sign-off on them, adjusting medications or marking for follow-ups as needed. This work is unpaid.
Each refill request made by a patient must be reviewed and signed off by the doctor. He or she is not paid for this work.
20 minutes is not enough time to adequately document a patient’s chart. A doctor will often make quick notes during the patient visit and complete the chart after visiting hours. Charts for those with complex problems and chronic conditions can take upwards of 30-60 minutes to document each visit – all done for free.
In our non-Council category, the winner was a superb piece by Terry Glavin – The Final Nail In The Coffin Of The Pakistani Pantomime? submitted by Simply Jews. It outlines the misconceptions about the war in AfPak and especially about our ‘ally’ Pakistan that have cost us dearly in blood and treasure.
Here are this week’s full results:
- *First place with 3 1/3 votes! The Razor – Working for Free: The Economics of Being a Primary Care Physician
- Second place with 2 2/3 votes – Simply Jews – Ron Paul 2012 and Paultards
- Third Place with 2 votes – New Zeal – Yes They Did!: Barack Obama, Cesar Chavez and Their Common Communist Roots
- Fourth place *t* with 1 2/3 votes – The Colossus of Rhodey – The Wrest Of The West
- Fourth place *t* with 1 2/3 votes – Joshuapundit – China’s Chief Of Staff Visits Israel To Discuss Strategic, Military Cooperation
- Fifth place *t* with 2/3 vote – GrEaT sAtAn”S gIrLfRiEnD – Sudanocide
- Fifth place *t* with 2/3 vote – VA Right! – Thoughts on Last Night’s Republican Debate
- Fifth place *t* with 2/3 vote – The Noisy Room – Reminds Me of What to Do Before I’m Dead
- Sixth place *t* with 1/3 vote – Right Truth – Losing the Habit of Work?
- Sixth place *t* with 1/3 vote – Bookworm Room – Honor Thy Father and Thy Mother
- *First place with 2 2/3 votes! – Terry Glavin – The Final Nail In The Coffin Of The Pakistani Pantomime? submitted by Simply Jews
- Second place with 2 votes – Big Peace – Ron Paul: The GOP’s Henry Wallace submitted by New Zeal
- Third place *t* with 1 2/3 votes – Bizzy Blog – AP Puts Dem Propaganda Spin on Obama’s ‘Me Too’ Tour submitted by Snapped Shot
- Third place *t* with 1 1/3 vote – City Journal – Why the Gender Gap Won’t Go Away. Ever. submitted by The Colossus of Rhodey
- Third place *t* with 1 1/3 vote – Sultan Knish – Anatomy Of Law Enforcement Impotence submitted by The Noisy Room
- Fourth place *t* with 1 vote – Peter Hitchens’ Blog – Police water cannons and plastic bullets? submitted by Joshuapundit
- Fourth place *t* with 1 vote – 2012 Campaign Report Patriot Action Network – Take A Bow submitted by Right Truth
- Fifth place *t* with 1/3 vote – Danny Ayalon – The Truth About The West Bank submitted by Bookworm Room
- Fifth place *t* with 1/3 vote – Daily Caller – Presidential debates should focus more on foreign policy submitted by GrEaT sAtAn”S gIrLfRiEnD
- Fifth place *t* with 1/3 vote – Atlas Shrugs – An Old Custom submitted by The Political Commentator
- Fifth place *t* with 1/3 vote – The League Of Ordinary Gentlemen – To Boldly Go Where No Two Men Have Gone Together Before submitted by Rhymes With Right
- Fifth place *t* with 1/3 vote -Atlas Shrugs – An Old Custom submitted by The Political Commentator
- Fifth place *t* with 1/3 vote – Atlas Shrugs – Obama Betrays Another Ally: U.S. to Deny Taiwan’s request, “We are so disappointed in the United States” submitted by VA Right!
- Fifth place *t* with 1/3 vote – JustOneMinute – All He Is Saying Is, Give War A Chance submitted by The Glittering Eye