Many physicians talk about getting the government or a some other third party to solve our economics woes. Neither our government, nor an outside entity is going to rescue physicians from the economic problems. The key is to be independent and have enough money in the bank to float one's living expenses for 6 months so low paying insurance companies and Medicare/Medicaid can be dropped.
It is not easy for physicians to be fiscally responsible. Everybody tells us we're supposed to be rich and the constant delayed gratification makes it even worse. When most of us finish, we have mounds of debt and either have just started a family or are preparing to start one. Then, many doctors leverage themselves to the max with big houses, fancy cars, and other trinkets. Anybody who wants to see how not to handle their finances, check out this recent article from CNN Money.
What really needs to happen is physicians need to live modestly the first 2 or 3 years out of residency and save up some money and pay off debt. It is a very un-American idea, but it does work. During this time, physicians need to save up a legitimate 6 months of living expenses. At this point, if they are in private practice, they can start dropping low paying plans. It is hard to bargain from a position of weakness, which is the position in which most docs place themselves. I know way too many doctors who are 5-10 years out of training and have maxed out credit cards and no money in the bank.
During medical school and training, I kept my expenses low, mostly by living in cheap places and having roommates. Yes, it was difficult, but I finished with only $60,000 of debt. I lived in an average apartment and kept my same car from beginning of residency and paid off my debt in 10 months. It was very satisfying.
Most dentists I know do exactly that. They work for somebody else for 2 or 3 years and save their money, then they start their own practice. They generally require payment at the time of service and regard insurance as the patient's insurance, not the doctor's insurance.
As far as care for the poor goes, hospitals can pay doctors an hourly or "by the case" rate for taking care of uninsured patients. It is already happening across the country. Let the hospitals collect whatever pittance Medicare throws them.
Fiscal responsibility is the key to solving our problems. Expecting anybody else to solve our problems will result in the same situation as welfare recipients waiting for the government to lift them out of poverty....it ain't gonna happen.
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