What’s Your Worth in the Matrix?

Posted on by

Do you want to know what a physician is worth in the employed model? Well, read this article in Medscape. It’s called Physician Pay Up, But Patient Demand, Labor Market Causing Struggles: Report and it breaks you down into numbers. Here are some highlights:

  • With the increased number of patients seeking care came increases in physician productivity, compensation, and revenues compared with the last quarter of 2021, according to a recent report.
  • The median investment or subsidy per full-time employed physician and advanced practice practitioner increased 14.4% from the fourth quarter of 2021 to $288,227 in the first quarter of 2022.
  • Bates defines the median investment or subsidy as the net patient service revenue minus total direct expense; investments or subsidies are divided by physician full-time equivalents. Direct expenses can include physician and staff salaries, facility costs, net supplies costs, and drug costs, he said.
  • While the median investment or subsidy per clinician increased 1.5% in comparison with the pandemic’s start in March 2020, this metric rose 8.9% from the first quarter of 2021, per the report.
  • Physicians’ increased productivity also resulted in higher compensation, according to the report. Physician compensation increased 3.6% quarter-over-quarter to $349,072 in the first quarter of this year, an increase of 6.6% when compared with the same quarter in the 2 previous years.
  • Expenses related to physicians and advanced practice providers shot up to a 2-year high of $946,602 for the first quarter of 2022; that’s a 7.1% increase from the last 3 months of 2021 and a 10.5% increase from the first quarter of 2021.
  • The increase in patient volume is driving patient access issues, said Bates. Patients want to see a physician and the practice often can’t fit them in for 6 weeks. While referring a patient to urgent care or the emergency department may be appropriate for primary care practices, it’s not a good option for other specialties, such as orthopedics, he explained.
  • Practices can extend hours, but that can be challenging given the labor shortage, said Bates. Large health systems have more flexibility and can provide patients with access to a same-day or next-day visit with a physician assistant or a nurse practitioner, but that can be difficult for smaller practices, he added.

Does this all make sense to you? Yeah, me neither. I think if you simplify it then it goes like this:

  • Employed docs are subsidized.
  • It costs a lot to pay them and their staff and that expense is going higher.
  • To pay for this, doctors will need to work longer hours or have more midlevels under them.
  • You are just a number.

OR

You can choose to do direct primary care and be your own boss.

I recommend that.

About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices.Dr. Farrago sold his Direct Primary Care practice in October 2020 but continues to receive care there as a patient.