Inflation=Physician Pay Cut

[HikingDO]

I am surprised I have not heard more about the 2022 fee cuts, at least to Medicare. But a handful of my other insurances pay at Medicare rates, so 2022 is going to be an upsetting year.

Nothing has gone down in price. I (& many many of us) are being paid less. Sounds disjointed to me...

What, being called a “health care hero” and getting free donuts from Krispy Kreme 2 years ago wasn’t enough? You want a raise too? Come on man, now you’re just being selfish😉

[Cubicle]

I am surprised I have not heard more about the 2022 fee cuts, at least to Medicare. But a handful of my other insurances pay at Medicare rates, so 2022 is going to be an upsetting year.

Nothing has gone down in price. I (& many many of us) are being paid less. Sounds disjointed to me...

[mayojayo]

funny how medicare cut physician compensation by 2% and we're all supposed to cheer and be happy that it wasn't 9% or whatever it was supposed to be. then you see how much they INCREASED the facility fees and it's an absolute slap in the face to physicians.

everyone in my network got raises this year, EXCEPT the employed physicians.

[wideopenspaces]

primary care at the VA I worked at sucked — tons of phone/message based work, tons of narcotics, dysfunctional system, chronic follow ups only with no acute care done in clinic, surgical specialties that would review the chart and refuse to see the patient as they were not surgical candidates. And the pay was maybe 10% less for the same overall workload. Much happier — even if not overjoyed - in a more traditional setting.

That's interesting. I was working in primary care doing mental health integration and our pcps were seeing 6-8 patients a day. Often had a resident too. And there was always an acute clinic for same day appointments. Seemed like a pretty good gig.

[wideopenspaces]

In my ophthalmology residency, the majority of our surgical training came from the VA. I think this is true of many ophtho departments.

Nearly all of the VA ophthalmologists who trained us were excellent surgeons and clinicians and most were not retirement age.

Well it's like they say- if you've seen one va, you've seen one va. I think having a va associated with a university academic institution with a medical school and residency means you will have high quality attendings. At least that has been my experience! Our VA is very good and most of the attendings in anesthesia/surgery/derm- the higher paying specialties- work at both the va and the university. I think the quality of care for our patients is excellent.

[abds]

Proceduralists go to the VA to retire. I know very few that are worth their already meager salary.

Perhaps more of a function of no incentive to work hard. I agree that the VA is where surgeons go to die however most of them I know are good surgeons who just want to not really work anymore.

[SEC Doc]

In my ophthalmology residency, the majority of our surgical training came from the VA. I think this is true of many ophtho departments.

Nearly all of the VA ophthalmologists who trained us were excellent surgeons and clinicians and most were not retirement age.

Agree - my best procedural training came at the VA.

[Dusn]

Proceduralists go to the VA to retire. I know very few that are worth their already meager salary.

In my ophthalmology residency, the majority of our surgical training came from the VA. I think this is true of many ophtho departments.

Nearly all of the VA ophthalmologists who trained us were excellent surgeons and clinicians and most were not retirement age.

[Ekanive23]

primary care at the VA I worked at sucked — tons of phone/message based work, tons of narcotics, dysfunctional system, chronic follow ups only with no acute care done in clinic, surgical specialties that would review the chart and refuse to see the patient as they were not surgical candidates. And the pay was maybe 10% less for the same overall workload. Much happier — even if not overjoyed - in a more traditional setting.

Proceduralists go to the VA to retire. I know very few that are worth their already meager salary.

[FIREshrink]

I certainly understand the above sentiment, but is anyone here who has worked for 10 years actually making less in nominal terms now than what they were making 10 years ago (assuming full-time work during the entire period). Finding someone like that is almost finding a unicorn. Sure everyone will tell you that they're working harder now, and I don't doubt this is the case for many. However, the reality is that no one outside of other docs is going to take any of this bellyaching seriously if pretty much everyone is making more money than they used to (whatever the reason may be).

Agree. Psychiatry went from a median of $135 to $275 over the last fifteen to twenty years. I don't know many production based psychiatrists making less than $300k. The median work RVUs have gone way up due to changes in CMS and AMA code changes peaking in 2021 with the Patients over Paperwork act; the conversion factor has also gone up over the last two decades from about $32 to now around $65 in 2022 and I think it will be near $70 in 2023. 2020-22 are anomalies due to covid and the impact covid had on survey benchmarks but comparing my first year out of residency 2003 to 2023 the typical psychiatrist should see a 100-150% increase in total comp.

[gap55u]

I think it's specialty dependent. In psychiatry where I am, the VA pays the same or better as everywhere else in town. Workload in outpatient at the VA is very similar as outpatient at the university. I see slightly fewer patients per week but they are sicker so it evens out. I think in other specialties the VA workload is much less than what you'd see in the community.

primary care at the VA I worked at sucked — tons of phone/message based work, tons of narcotics, dysfunctional system, chronic follow ups only with no acute care done in clinic, surgical specialties that would review the chart and refuse to see the patient as they were not surgical candidates. And the pay was maybe 10% less for the same overall workload. Much happier — even if not overjoyed - in a more traditional setting.

[Lordosis]

It's hard to say with my particular job. I'm on a compensation based model so if the payers pay more I will ultimately get more. But I'm also in still kind of a buildup phase. I've been at my job for over 6 years but my panel continues to grow and the maximum I see in a typical day does not really go up but the average amount of patients I see per day seems to be increasing. I have less lightly scheduled days and more moderate to packed days. Also in primary care we get insurance incentives and ACO incentives based on attributed lives. And as I gain attributed lives I see these numbers increasing. They're also seems to be a delay and when they establish in when those come through.

Other than the period where my salary was based on the covid shutdown my salary has gone up consistently every quarter. I feel I must be reaching a plateau but I am quite happy where I am.

[Hawkeye225]

Well based on above I don't think you personally qualify, I'm gonna have to take back the unicorn status. In my original post I was factoring increased days worked.



But I'm a little confused about what you mean by "not factoring" and whether you are saying the 6% reduction is despite the increased work load. So maybe above is not disqualifying. Nevertheless, I also was limiting my claim to people who worked full-time during the entire period:



It sounds like that in your case your $/hr rate has gone down between 2010 and 2020. That is very common. In fact, it has happened to most every doc I know, including myself. In my own case, I work a bit more and I am more efficient, so my total income was higher in 2020 than 2010.

Come to think of it 2020 to 2010 is really a terrible time period to use because of COVID. 2019 to 2009 would be better.

The 70+ partners in my group qualified and I did until last year when I left the partnership and our salaries didn't move much at all last year. Bottom line is that we see more cases, work more days and make less/day compared to the peak of 10-12 years ago or somewhere in there. I'm not factoring in # of cases or days worked but only salary/shift and that is 18%% less/shift. When adding back the increased number of days worked, it is overall 6% less/yr. It is a clear decrease in income and doesn't even take into account the amount paid/case. So if one was able to add the increased case load in, the decrease would be >18%.

[Tim]

Raise? That's a word I've never seen while in a long career in medicine. Would someone be polite enough to explain what this is in the English language?

“This is of course true, however with Medicare part A premiums increasing 6% and part B premiums and deductibles increasing 15%”
Your time is coming. Raise is defined as premiums increasing. Not to mention Part D, which is a completely different shell game.
A raise is defined as Medicare gives you some but takes more. Net result is a loss.
Just math.

[AR]

No. Overall 6% lower in 2020 (likely more than 6% next year) than 2010 income not factoring in the increased days worked.

To be clear, I am speaking of a full time partner's salary of which I was one for many years. I'm now part time as I finish up my career but I'm only referencing full parter's salary. I'm clarifying this since some here know that I'm part time now.

Well based on above I don't think you personally qualify, I'm gonna have to take back the unicorn status. In my original post I was factoring increased days worked.

Sure everyone will tell you that they're working harder now, and I don't doubt this is the case for many.

But I'm a little confused about what you mean by "not factoring" and whether you are saying the 6% reduction is despite the increased work load. So maybe above is not disqualifying. Nevertheless, I also was limiting my claim to people who worked full-time during the entire period:

assuming full-time work during the entire period

It sounds like that in your case your $/hr rate has gone down between 2010 and 2020. That is very common. In fact, it has happened to most every doc I know, including myself. In my own case, I work a bit more and I am more efficient, so my total income was higher in 2020 than 2010.

Come to think of it 2020 to 2010 is really a terrible time period to use because of COVID. 2019 to 2009 would be better.