From: Jon Purdy, DPM
I have a different take on this strategy, and it has to do with the microeconomics of running a practice. One needs to calculate the cost of investing staff time in the recommended “…contact the patient’s insurer to verify active policy, physician network status, procedure coverage, and prior authorization requirements before the appointment…” Supposed the patient does not show up?
We need to remember it is the patient’s responsibility to know everything stated above. What we do is out of convenience for the patient and our bottom line, but not obligation. Most EMRs will give a snapshot of current activity and benefits coverage which we check prior to the visit. Once the patient is established, we have them sign a statement on every visit that what they gave us is active and the coverages are as stated. It now becomes the patient's known responsibility to pay the bill if something has changed they did not make us aware of it. In the case of prior authorizations, many can be done in a couple of minutes while the patient is in the office. For those cases that take time, we check and get prior authorizations done later for the next visit.
True costs of employees are more than most are aware of. One quick example is asking a physician what it costs for a twenty dollar an hour employee to work for an hour. Their response is usually, twenty dollars. One quickly forgets to add payroll fees and taxes, benefits, Workers’ Comp, and liability insurance, to name a few. The cost is usually about thirty percent more. Microeconomics is a fascinating topic and can change the way one practices.
Jon Purdy, DPM, New Iberia, LA
From: Christopher Lotufo, DPM
I read with interest regarding the topic “Five Questions to Ask About wRVU Compensation.” Having been employed by a multi-specialty group and compensated under a wRVU system for the last 7 years, I have come to realize a few things specifically regarding DPM compensation. Ultimately, it is the conversion factor (CF) that drives a physician’s pay, and this is what needs to be negotiated. Medical groups, hospitals, and academic institutions use data from the MGMA and AMGA to calculate physicians pay and conversion factors for all medical specialties. The data they gather is mostly from surveys of these institutions and it is my belief that the data regarding DPMs is lacking.
A busy DPM performing all aspects of foot and ankle surgery can generate productivity numbers on par or in some cases exceed productivity numbers of an orthopedic foot and ankle surgeon, yet the current...
Editor's note: Dr. Lotufo's extended-length letter can be read here.
