- Joined
- Jan 15, 2002
- Messages
- 238
- Reaction score
- 0
A little discouraging...I'd love to go back to my little Nirvana.
http://www.theunion.com/article/20070119/NEWS/101190166
(Editor's Note: Six months ago, The Union reported that western Nevada County had lost six family doctors, and residents were having trouble finding general physicians to serve them. This report continues The Union's investigation into the state of medical care in the area.)
ooo
If you want to know why western Nevada County can't keep or attract family doctors, just crunch the numbers. Three local doctors did.
After looking at those numbers, Dr. Dan Bibelheimer left 31 years in general practice to head up a local doctor's organization.
Dr. Greg Edwards left to take a job at Kaiser Health Systems.
Dr. Kirsten Truman left her practice after six years to become a hospitalist with Sierra Nevada Memorial Hospital.
A year ago, they were among 20 family doctors practicing in the area. Today, 13 family doctors remain, Bibelheimer said.
Those who left all point to the same reasons: The rising price of running an office, private and government insurance reimbursements that fall far short of costs and an economic environment where stockbrokers can make triple what doctors earn.
"These are people who go to college until they're 28, and then they enter the mainstream $100,000 in debt from school loans - making $80,000 to start," said Dave Scinto, a Grass Valley accountant who handles physicians' books.
"Lawyers here make about $100,000 to $200,000. Stockbrokers here and in the state can make $100,000 to $300,000. But the guy whose treating your kid and grandma is making $80,000 to $120,000" yearly after expenses, Scinto said.
"Doctors are underpaid in my opinion, and if they make a mistake, you know what happens," Scinto added, referring to lawsuits.
Bibelheimer now is director of the local chapter of the Independent Physicians Association, an organization owned by area doctors. He said national media routinely place the average American primary care doctor's salary at $165,000 in take-home pay. Primary care doctors include family physicians, pediatricians that take care of children, and those in internal medicine.
But in Bibelheimer's case, he said, "I never saw that kind of money. A few here have made that, but most are under $100,000 and 40 percent are at $80,000 and under."
Bibelheimer took a survey of 29 of the area's 42 primary care doctors in March 2006 and found one who made more than $150,000 per year.
In a national survey taken last May of more than 19,000 physicians by recruiting firm Jackson and Coker, primary care doctors averaged $155,000 per year in take-home earnings. That broke down to $142,000 for family doctors, $156,000 for pediatricians and $167,000 for those in internal medicine.
A similar survey taken recently by Physicians Search of Anaheim of 3,000 national doctors revealed an average net yearly earnings of $152,000 for primary care physicians, $148,000 for family doctors, $150,000 for pediatricians and $160,000 for internists.
With those numbers driving area doctors out of practice, many residents can't get an appointment with the remaining physicians.
A better deal
Dr. Greg Edwards practiced in a physicians group with Bibelheimer before it was dissolved. He thought about keeping a practice in western Nevada County, where he still lives.
"You have to go $80,000 to $100,000 in debt to start a practice," and that was daunting, Edwards said.
He also looked at federal and private insurance reimbursements, which do not keep up with the rising cost of business.
"No one's starving, but they're not getting rich either," Edwards said.
Then colleagues suggested he look at the Kaiser Health Systems.
Kaiser "brought a lot of money to the table and made me an offer I couldn't refuse," Edwards said.
In private practice, Edwards made three-fourths what he is making now and had no health benefits. Since hiring on with Kaiser last year, he goes to an office in Lincoln he doesn't have to staff, pay or maintain.
"I show up, see patients and take home a paycheck," Edwards said. "It's not just the money. It's the time off, and less time with the business and the paper work."
Another one bites the dust
Dr. Kirsten Truman closed her Nevada County practice in December. She looks forward to her days making rounds with hospital patients and a minimal business involvement.
"Your business overhead runs about two-thirds of what you collect," Truman said recently about her family practice. "You might make $120,000 or $130,000 if you work your butt off," Truman said. "I don't think I've ever cracked $100,000. I'm in the $90s now (as a hospitalist), and I work less."
Truman said doctors are going to the Kaiser system because they are willing to pay the $50,000 to $100,000 per year to subsidize a practice, so that doctors can take home $130,000 to $150,000 annually with few headaches.
Another frustration for Truman was to see her practice grow while her income remained the same, a reverse of the traditional business payoff.
"The bigger you get, the more infrastructure you need," Truman said. "When you start to get big, all kinds of things change."
Insurance companies and MediCare haggle with doctors to discount large portions of their charges. They scrutinize bills and payouts, and sometimes suggest a doctor is committing fraud when questioning charges, Truman said.
"And people wonder why their doctors are running around all day," Truman said. "You need at least 20 patients a day unless they're paying carte blanche. It's nuts. It's falling apart."
To compensate, some doctors are turning to minor plastic surgery services such as dermabrasion and botox injections, Truman said.
"(It) is ridiculous, because that's not what we got into medicine for," Truman said.
More bad news
Scinto suspects MediCare and private insurance compensation rates will remain low because of the upcoming onslaught of Baby Boomers entering the system.
"They know the problem will get much bigger and they may have to cap the rates now," Scinto said. "The government is filtering the problem down to the general practitioners."
But Truman knows there is hope for those primary care doctors still practicing because the entire medical system feeds off them for referrals to hospital procedures and specialists.
"They know they need you because you're a vital part of the organization," funneling patients into the system, Truman said.
According to Bibelheimer, "Canada and the United Kingdom have figured out primary care is important, and through their national systems, they're raising their salaries."
Truman has not raised hers, but she feels like her life has been uplifted.
"So now I work half as much, make the same amount of money and I don't run a business on the weekends anymore," Truman said. "I have a life and I work to live, not live to work. I'm devoted, but I'm not as good a physician if I work too much and I'm overwrought."
ooo
To contact Senior Staff Writer Dave Moller, e-mail [email protected] or call 477-4237.
Task force putting rescue plan together
When Craig Wilcox recently took over doctor recruitment at Sierra Nevada Memorial Hospital, he knew he had a formidable task before him.
"We're putting together a rescue plan," the hospital's new business development director said. "We have a (medical) community in crisis."
Family doctors provide the referrals that keep the specialists in business. But with western Nevada County's loss of seven family doctors in the past year due to high costs and low net salaries, the remaining 13 physicians cannot keep up with the patients, and the specialists feel the pinch.
To help find family physicians, the hospital set up a task force last summer of physicians and area leaders to brainstorm solutions. Their next meeting, which is not public, is set for Wednesday.
There are two suggestions that will immediately be thrown on the table to entice family doctors, Wilcox said.
"The hospital does its own clinics, or we recruit into stable and existing practices," or both, Wilcox suggested. "With existing practices, we can get them to national (salary) norms in that setting" without asking them to shell out large amounts to establish a new business.
Wilcox was reluctant to get much more specific prior to the meeting, but he did say, "I've interacted with a practice in the community where the income was higher or comparable to national norms. If one physician can earn at national norms here, then it's possible."
To hit the salary norms, physicians have to ask themselves some tough questions, Wilcox said: How many patients do they want? How many staff members they can afford? How much they want to work?
He also has the Nevada County evergreen factor at his behest.
"Not everybody wants to be in a large area or down the street from Home Depot," Wilcox said.
ooo
To contact Senior Staff Writer Dave Moller, e-mail [email protected], or call 477-4237.
According to a survey of 19,000 American doctors in May of 2006 done by physician recruitment firm Jackson and Coker, the average general practice M.D. takes home $155,000 per year.
A survey of 29 general practice doctors in western Nevada County in March 2006 revealed their annual take-home earnings:
Less than $80,000: 12
$80,000 to $100,000: 7
$100,000 to $120,000: 3
$120,000 to $150,000: 6
$150,000: 1
- Dave Moller
http://www.theunion.com/article/20070119/NEWS/101190166
(Editor's Note: Six months ago, The Union reported that western Nevada County had lost six family doctors, and residents were having trouble finding general physicians to serve them. This report continues The Union's investigation into the state of medical care in the area.)
ooo
If you want to know why western Nevada County can't keep or attract family doctors, just crunch the numbers. Three local doctors did.
After looking at those numbers, Dr. Dan Bibelheimer left 31 years in general practice to head up a local doctor's organization.
Dr. Greg Edwards left to take a job at Kaiser Health Systems.
Dr. Kirsten Truman left her practice after six years to become a hospitalist with Sierra Nevada Memorial Hospital.
A year ago, they were among 20 family doctors practicing in the area. Today, 13 family doctors remain, Bibelheimer said.
Those who left all point to the same reasons: The rising price of running an office, private and government insurance reimbursements that fall far short of costs and an economic environment where stockbrokers can make triple what doctors earn.
"These are people who go to college until they're 28, and then they enter the mainstream $100,000 in debt from school loans - making $80,000 to start," said Dave Scinto, a Grass Valley accountant who handles physicians' books.
"Lawyers here make about $100,000 to $200,000. Stockbrokers here and in the state can make $100,000 to $300,000. But the guy whose treating your kid and grandma is making $80,000 to $120,000" yearly after expenses, Scinto said.
"Doctors are underpaid in my opinion, and if they make a mistake, you know what happens," Scinto added, referring to lawsuits.
Bibelheimer now is director of the local chapter of the Independent Physicians Association, an organization owned by area doctors. He said national media routinely place the average American primary care doctor's salary at $165,000 in take-home pay. Primary care doctors include family physicians, pediatricians that take care of children, and those in internal medicine.
But in Bibelheimer's case, he said, "I never saw that kind of money. A few here have made that, but most are under $100,000 and 40 percent are at $80,000 and under."
Bibelheimer took a survey of 29 of the area's 42 primary care doctors in March 2006 and found one who made more than $150,000 per year.
In a national survey taken last May of more than 19,000 physicians by recruiting firm Jackson and Coker, primary care doctors averaged $155,000 per year in take-home earnings. That broke down to $142,000 for family doctors, $156,000 for pediatricians and $167,000 for those in internal medicine.
A similar survey taken recently by Physicians Search of Anaheim of 3,000 national doctors revealed an average net yearly earnings of $152,000 for primary care physicians, $148,000 for family doctors, $150,000 for pediatricians and $160,000 for internists.
With those numbers driving area doctors out of practice, many residents can't get an appointment with the remaining physicians.
A better deal
Dr. Greg Edwards practiced in a physicians group with Bibelheimer before it was dissolved. He thought about keeping a practice in western Nevada County, where he still lives.
"You have to go $80,000 to $100,000 in debt to start a practice," and that was daunting, Edwards said.
He also looked at federal and private insurance reimbursements, which do not keep up with the rising cost of business.
"No one's starving, but they're not getting rich either," Edwards said.
Then colleagues suggested he look at the Kaiser Health Systems.
Kaiser "brought a lot of money to the table and made me an offer I couldn't refuse," Edwards said.
In private practice, Edwards made three-fourths what he is making now and had no health benefits. Since hiring on with Kaiser last year, he goes to an office in Lincoln he doesn't have to staff, pay or maintain.
"I show up, see patients and take home a paycheck," Edwards said. "It's not just the money. It's the time off, and less time with the business and the paper work."
Another one bites the dust
Dr. Kirsten Truman closed her Nevada County practice in December. She looks forward to her days making rounds with hospital patients and a minimal business involvement.
"Your business overhead runs about two-thirds of what you collect," Truman said recently about her family practice. "You might make $120,000 or $130,000 if you work your butt off," Truman said. "I don't think I've ever cracked $100,000. I'm in the $90s now (as a hospitalist), and I work less."
Truman said doctors are going to the Kaiser system because they are willing to pay the $50,000 to $100,000 per year to subsidize a practice, so that doctors can take home $130,000 to $150,000 annually with few headaches.
Another frustration for Truman was to see her practice grow while her income remained the same, a reverse of the traditional business payoff.
"The bigger you get, the more infrastructure you need," Truman said. "When you start to get big, all kinds of things change."
Insurance companies and MediCare haggle with doctors to discount large portions of their charges. They scrutinize bills and payouts, and sometimes suggest a doctor is committing fraud when questioning charges, Truman said.
"And people wonder why their doctors are running around all day," Truman said. "You need at least 20 patients a day unless they're paying carte blanche. It's nuts. It's falling apart."
To compensate, some doctors are turning to minor plastic surgery services such as dermabrasion and botox injections, Truman said.
"(It) is ridiculous, because that's not what we got into medicine for," Truman said.
More bad news
Scinto suspects MediCare and private insurance compensation rates will remain low because of the upcoming onslaught of Baby Boomers entering the system.
"They know the problem will get much bigger and they may have to cap the rates now," Scinto said. "The government is filtering the problem down to the general practitioners."
But Truman knows there is hope for those primary care doctors still practicing because the entire medical system feeds off them for referrals to hospital procedures and specialists.
"They know they need you because you're a vital part of the organization," funneling patients into the system, Truman said.
According to Bibelheimer, "Canada and the United Kingdom have figured out primary care is important, and through their national systems, they're raising their salaries."
Truman has not raised hers, but she feels like her life has been uplifted.
"So now I work half as much, make the same amount of money and I don't run a business on the weekends anymore," Truman said. "I have a life and I work to live, not live to work. I'm devoted, but I'm not as good a physician if I work too much and I'm overwrought."
ooo
To contact Senior Staff Writer Dave Moller, e-mail [email protected] or call 477-4237.
Task force putting rescue plan together
When Craig Wilcox recently took over doctor recruitment at Sierra Nevada Memorial Hospital, he knew he had a formidable task before him.
"We're putting together a rescue plan," the hospital's new business development director said. "We have a (medical) community in crisis."
Family doctors provide the referrals that keep the specialists in business. But with western Nevada County's loss of seven family doctors in the past year due to high costs and low net salaries, the remaining 13 physicians cannot keep up with the patients, and the specialists feel the pinch.
To help find family physicians, the hospital set up a task force last summer of physicians and area leaders to brainstorm solutions. Their next meeting, which is not public, is set for Wednesday.
There are two suggestions that will immediately be thrown on the table to entice family doctors, Wilcox said.
"The hospital does its own clinics, or we recruit into stable and existing practices," or both, Wilcox suggested. "With existing practices, we can get them to national (salary) norms in that setting" without asking them to shell out large amounts to establish a new business.
Wilcox was reluctant to get much more specific prior to the meeting, but he did say, "I've interacted with a practice in the community where the income was higher or comparable to national norms. If one physician can earn at national norms here, then it's possible."
To hit the salary norms, physicians have to ask themselves some tough questions, Wilcox said: How many patients do they want? How many staff members they can afford? How much they want to work?
He also has the Nevada County evergreen factor at his behest.
"Not everybody wants to be in a large area or down the street from Home Depot," Wilcox said.
ooo
To contact Senior Staff Writer Dave Moller, e-mail [email protected], or call 477-4237.
According to a survey of 19,000 American doctors in May of 2006 done by physician recruitment firm Jackson and Coker, the average general practice M.D. takes home $155,000 per year.
A survey of 29 general practice doctors in western Nevada County in March 2006 revealed their annual take-home earnings:
Less than $80,000: 12
$80,000 to $100,000: 7
$100,000 to $120,000: 3
$120,000 to $150,000: 6
$150,000: 1
- Dave Moller
