Stephen Schimpff Wants To Spend More Than 10 Minutes With His Patients

You call for an appointment and are told it will be about 20 days.

You arrive on time only to sit in the apt named waiting room for 40 minutes.

You see your primary care doctor (PCP).

You start to explain why you came in.

You’re interrupted within about 23 seconds.

The doctor asks you some questions.

You receive a hurried exam where he scribbles a prescription, suggests you see the specialist and off you go, all within about 12 minutes.

At the exit desk you are told you owe a $30 co-pay. “Visa or MasterCard please.”

No time for delving deeply into your issues. No time to build trust. No time for compassion. No time for actual healing.

Why so quick?

Let’s look at the numbers.

According to the New York Times a PCP earns on average $150,000 per year.

If the PCP has a private practice, in order to earn $150,000, he or she needs to bring in about $350,000 to also cover office expenses.

Given what insurers like BlueCross, Aetna, United Health Care, Medicare and Medicaid pay per visit, the doctor needs to see about 25 patients per day.

That is $30 to the PCP’s pocket for each visit.

Said a different way, the PCP has to see 15 patients to cover expenses.

Any patients over 15 and the income goes to him or her.

So the PCP works for others until about 2pm.

The typical PCP takes 24 phone calls per day, 17 emails, processes 12 prescription refills (above those handled during visits), and reviews 20 laboratory reports, 11 x-ray reports and 14 specialist consult reports.

These are all done outside of the visit and obviously take substantial time.

Try another breakdown.

A PCP who worked for a well-known HMO in California earned $140,000 and was assigned a panel of 2,200 patients.

That is $64 for each patient for the entire year.

The next question we’d ask is how much did the patient pay for all that coverage?

Probably a LOT more than $64.

Which raises the real question: where is all that money we’re paying for healthcare really going?

Read Stephen Schimpf’s answer on