golfing eagles |
08-02-2024 09:03 AM |
Quote:
Originally Posted by retiredguy123
(Post 2355220)
If a medical doctor has 10 patients in a nursing home, they can visit the facility every day, 7 days per week, and bill Medicare for 70 home visits every week, even though they may just stop in to ask how they are feeling. For 70 visits, they can collect about $5,600 or more even though they may only spend less than a hour in the facility. If they have 5 nursing homes on their route, they can make $28,000 per week. I have seen this happen.
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Quote:
Originally Posted by blueash
(Post 2355439)
You are making that up and have no idea what time is required and what Medicare pays. Firstly a simple visit as you described to a nursing home/ long term care facility in 2024 pays the doctor a huge $39.64. This would include reviewing the nursing notes since the previous visit, writing a visit note, reviewing any labs. It would not include a complete physical exam of the patient, if that were required the visit would be billed at a higher code.
I can assure you that no doctor is able to do the work on a single patient including those services in 6 minutes. You've seen how long it takes a doctor to enter a note in an electronic medical record. Figure 10 minutes, then go to the next patient, start over. You do 6 patients an hour and are paid about 240 dollars. I just paid more than that for a plumber for an hour of work. And nobody was going to die if he got something wrong.
If taking care of nursing home patients made doctors rich there wouldn't be a shortage of doctors willing to take on their care. They often have complex illnesses, on multiple medications, cannot clearly define their own needs and symptoms, are cared for by staff that may not be excellent at either documentation or provision of care, etc. It ain't easy and it doesn't pay well compared to almost any other field of medicine.
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Again, absolutely correct. Before I dropped out of taking care of patients at our nursing home, I had about 60. Using RG's math, I would have made $168,000/ week or $8.7 million/year on that alone. In reality, I made about $14,000/ year----before overhead and taxes. It is not a desirable facet of practicing medicine---because you're right, the patients often have complex medical problems, many have severe dementia and mobility issues leading to decubiti and intercurrent infection all in a facility that is not usually staffed by the best nurses and others. Also, the families of these patients, while well meaning, tend to be a PITA. It's not just the ever-increasing time it takes for a visit and documentation, there are the endless phone calls, usually pretty stupid, day and night. Then, at least in NY, the state health department watches these places like a hawk, ready to pounce on any lack of documentation with draconian penalties. One of my partners was fined $15,000 for "failing" to do a breast examination on a 99-year-old woman.
Anyone who thinks that nursing home care is a desirable aspect of practicing medicine, or plans to "get rich" doing it, needs to switch from geriatrics to psychiatry.
But to dispute one aspect of that post, I suppose a plumber could cause a massive leak to the ceiling of a watertight home and create a life and death scenario
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