on 5/22/07 10:51 AM, Stuart Frankel at [log in to unmask] wrote:


> James McCarty wrote:
> 
>> I guess the difference between my work and yours is that while I would never
>> pretend to understand modes, my patients read something on the internet for
>> 15 minutes and think they understand it better than I do :)
> 
> I don't see the problem - if they already understand things,
> then they must be consulting you for very high-level help,
> and you could charge accordingly.

They don't come in to consult. They come in to argue. They really do think
they know more than I do.

And we can't "charge accordingly." Our fees are set by the insurance
company--no negotiating allowed. Even if you are the chairman of the
department at the medical school, or if you have a particular expertise in a
certain disease, it doesn't matter. You get paid exactly the same for that
office visit as the guy fresh out of residency. And you never get a
raise--well, actually you get a pay cut, because the cost of operating your
office keeps going up while the reimbursement you get stays the same. Some
incentive for excellence!

Don't worry, though. In a few years you won't have to see us horrible
incompetent American doctors. You'll be ushered into a room with a TV
camera, where you'll consult with someone in Thailand or India who's willing
to do it for a lot less. Hey, price is all that matters, right? It's the
Wal-Mart way.

-- 
James R. (Jay) McCarty, MD
Fort Worth, TX

"Sine arte, scientia nihil est"