I have a young son who asked me the other day why Nat, our CEO, paid me for my work. This caught me by surprise and I asked what had prompted the question. He told me that he understood why construction workers got paid for building roads, why firefighters got paid for putting out fires and why NHL hockey players got paid for scoring goals (something I struggle to understand sometimes myself).
But he couldn’t understand why Nat would pay me for thinking about ways to help doctors get paid more. What it came down to in his mind, I realized, was that I wasn’t making or doing or anything people could actually see—roads, heroic rescues, goals.
So I explained to my son that I get a salary for all of the services I provide and time I spend for Hello Health—whether that means giving a talk at a conference, sitting on the plane en route to that conference, or sitting at my computer writing a blog post. For my efforts, twice a month, as if by magic, money is transferred into my bank account. No fuss, no muss.
Through this exchange with my son I was aware of just how pertinent it was to the problem HH is trying to solve every day: helping doctors close the revenue gap between the work they get paid for and the work they actually do.
To get paid, a doctor typically has to provide a service to a patient for which an insurance code exists so he can make a claim for reimbursement. Of course, that claim may or may not be approved.
Not quite as straightforward as the “as if by magic” pay that I collect, is it?
What’s more, doctors also do a heck of a lot of stuff during the day that they don’t get paid for at all. (Take a look at this 2010 NEJM article if you don’t believe me.)
Insurance companies don’t pay for the things doctors do above and beyond patient visits: coordinating patient care, running the practice, and keeping all the balls up in the air, so to speak.
For many family doctors, there’s no salary, nor is there a “Nat” who deposits money into their checking accounts. So I wonder how a primary care doctor would have responded if his or her young child had asked the same question?
It may have gone something like this:
Little tyke: “Daddy, where do you get money?
Family doc: “Well, son, Daddy is at the mercy of 17 insurance companies and the feds, and he has 2 full-time FTEs to ensure he gets reimbursed for helping his patients. And 27% of the time he doesn’t actually get reimbursed.”
Little tyke: “Who are the feds, and what’s an FTE..?”
Family doc: “Er….How about we talk about how babies are made instead?”
The way doctors are compensated isn’t likely to change any time soon. But that doesn’t mean we shouldn’t try to find ways to increase practice revenue so it more accurately reflects the amount of time and effort doctors put into running their practices and providing the best care.
Steven Ferguson is the patient management officer at Hello Health, the revenue generating EHR platform for primary care practices supporting practice vitality through patient engagement and electronic medical revenue.