L****n
发帖数: 12932 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: doctor1999 (doctor 1999), 信区: MedicalCareer
标 题: radiologist 真是抢钱哪
发信站: BBS 未名空间站 (Tue Jan 24 10:40:05 2012, 美东)
A friend of mine just did a PET ct. The whole procedure takes less than 2
hours. First they gave her some injection of nuclear material then let her
rest in a reclining chair in a small room for 1 hour. Then she was taken to
do the PET CT, which took 20 minutes.
The bill submitted to insurance consists of:
(1) $5800 for the use of the facility (I guess that's for the use of the
reclining chair in the small room?)
(2) $1800 for the radiologist who wrote the PET ct report.
Can anyone tell me how much will go to the radiologist? I am guessing 1800
plus 50% of $5800, which is $4700. The total time the radiologist spent on
the pet ct is probably less than 1 hour. So his hourly rate is around $5000.
I think I strongly support Obamacare that cut off payments to doctors. This
is too much!!!!!! | R*******t
发帖数: 367 | 2 It is the hospital bill and technical fees. Majority of the dollars goes
into gospital's pocket. Why radiologists get the blame neh?
A stereotactic breast biopsy is charged close to 7k . A 30 minutes procedure
. The radiologist gets a very small portion of it. | C*****D
发帖数: 1299 | 3 If it is true, it is not that bad.
Assume $1800 is the professional fee, or billable amount, considering all
the factors, finally only can get 1/3 back, means $600.
$5800 is the technical components, usually only get 10-15% into physcian
pocket.
if working on the patient directly needs 2 hors, the physician might need
another hour for paperwork. Breaking down, the hour rate is only around $300
-400.
In academic, my revenue is 3 times of my salary.
So for that particular person, in academic get around $200K, private might
get $500K, but has to pay overhead, insurance etc.
From my understaning, the biggest problem is not the fee rate, is the
unnecessary tests. Obamacare will change the rate only, the consequence is
that to make up the loss, more and more tests will be ordered, and the
waiting time will be longer and longer.
to
【在 L****n 的大作中提到】
: 【 以下文字转载自 MedicalCareer 讨论区 】
: 发信人: doctor1999 (doctor 1999), 信区: MedicalCareer
: 标 题: radiologist 真是抢钱哪
: 发信站: BBS 未名空间站 (Tue Jan 24 10:40:05 2012, 美东)
: A friend of mine just did a PET ct. The whole procedure takes less than 2
: hours. First they gave her some injection of nuclear material then let her
: rest in a reclining chair in a small room for 1 hour. Then she was taken to
: do the PET CT, which took 20 minutes.
: The bill submitted to insurance consists of:
: (1) $5800 for the use of the facility (I guess that's for the use of the
| P********r
发帖数: 92 | 4 Thanks for the detailed break down info.
Please bear with me that i have no knowledge of any fees. Naive Qs:
if that's the case, should the health reform target on the 5800 technical
components? Why does the hospital charge more than $5000 for an hour's use
of hospital facility...
300
【在 C*****D 的大作中提到】
: If it is true, it is not that bad.
: Assume $1800 is the professional fee, or billable amount, considering all
: the factors, finally only can get 1/3 back, means $600.
: $5800 is the technical components, usually only get 10-15% into physcian
: pocket.
: if working on the patient directly needs 2 hors, the physician might need
: another hour for paperwork. Breaking down, the hour rate is only around $300
: -400.
: In academic, my revenue is 3 times of my salary.
: So for that particular person, in academic get around $200K, private might
| L****n
发帖数: 12932 | 5 my replies are in the original thread: http://www.mitbbs.com/article_t/MedicalCareer/31456985.html
procedure
【在 R*******t 的大作中提到】
: It is the hospital bill and technical fees. Majority of the dollars goes
: into gospital's pocket. Why radiologists get the blame neh?
: A stereotactic breast biopsy is charged close to 7k . A 30 minutes procedure
: . The radiologist gets a very small portion of it.
| R*******t
发帖数: 367 | 6 去看了。蒙古大夫说的条理清晰，要我就哑嗑说不出什么了。哈哈。
【在 L****n 的大作中提到】
: my replies are in the original thread: http://www.mitbbs.com/article_t/MedicalCareer/31456985.html
:
: procedure
| b*w
发帖数: 2062 | 7 1. totally agree, those rad or radonc docs who make a mil a year owns the
equipment so they are paid (as the tech fee you mentioned) whenever those
equipment are used, either for imaging or treatment.
2. rad has quite high work load IMO because of little "down" time compared
with other specialties.
procedure
【在 R*******t 的大作中提到】
: It is the hospital bill and technical fees. Majority of the dollars goes
: into gospital's pocket. Why radiologists get the blame neh?
: A stereotactic breast biopsy is charged close to 7k . A 30 minutes procedure
: . The radiologist gets a very small portion of it.
| C*****D
发帖数: 1299 | 8 those fancy machines do cost a lot. The hospitals have to pay all indirect
costs, such as building, utility, supporting personnel etc.
The bigger the investment, the higher return people wants.
在我看来, 美国health care cost 要减下来, 比较渺茫. 现在已进入一个高消费死循
环.因为医生和医院都是整个生物医学工业中的一链.
如果$5800降一半, 医院要亏, 那就先裁员, 没有利润, 机器就不买, 医疗器械公司就
没生意, 不挣钱就切R&D, 码工就失业. 所以器械公司鼓动医院买新机器,医院鼓励医生
用贵的tests 和药.
医院因为竞争关系也要不停造新大楼, 买最先进机器, 高薪聘能人. 不象中国一个调控
就能降下来.
要降下来, 就得停止基建, 停止买机器, 停止开发贵的药, 那些奶酪谁能动?
【在 P********r 的大作中提到】
: Thanks for the detailed break down info.
: Please bear with me that i have no knowledge of any fees. Naive Qs:
: if that's the case, should the health reform target on the 5800 technical
: components? Why does the hospital charge more than $5000 for an hour's use
: of hospital facility...
:
: 300
| f*********r
发帖数: 1233 | 9 一个放射科，一个病理科，在国内也就是“辅助科室”，没啥分量。老美就不一样了。
没有这俩科室出报告，其它科室就啥也不能干，在诊断上就是睁眼瞎。这里有水平问题
，不会看平片的大夫有的是，更不要说其它modality。也有会看但不上心看的，反正有
放射科出报告，何苦自己去研究。再有就是法律和制度的因素。就算专科大夫能明确发
现片子上的问题，但没有放射科的报告，他们就不能轻举妄动。总之，多种因素，让这
俩辅助科室反而成了重中之重。有了这样的资本，宰人当然没商量。 | A*******s
发帖数: 9638 | 10 5800+ 1800.
$5800 is the bill. insurance may pay 2000, medicare/medicaid may be only
1000 or less. The fee is the highest at the biginning of use.
$1800 for PET reading is excessive indeed. Reimbursement is at most
400 or less.
MRI reading fee is only $100 for commercial insurances, medicare/medicaid
only pays $50.
Why bill so much? Non-insured is a big deal for the hospital. That's why I
posted a thread about ppl who don't buy health insurance. Obamacare has to
fix these non-insurers, not paid by tax payers but those noninsurer
themselves.
Then democrats have to violate the human right, is it sarcastic? | | | x*****0
发帖数: 101 | 11 医疗费高的拫源是因为美国医生工会通过限制医生人数, 人为造成医生短缺, 来提高医
生工资.
关于无保险病人又有医生们想误导不知内情的读者.
保险公司和医生及医院有约定价格. 假定约定价格$100,但医生故意开个$500账单忽悠
公众好象他们吃了亏. 如果因为某种原因保险公司不付, 病人就惨了. 医生就找病人追
的就不是约定的价格$100了, 而是账单上的$500了.
因为美国医生知道无保险病人没有negotiation power for price, 理论上医生可以在
账单上填任意一个数字,病人只有一个选择, 按账单数字付. MIT 商学院有这方靣研究
调查.MIT结论是,尽管有的无保险病人付不出分文, 但对同样的治疗医生从无保险病人
得到的钱平均要比有保险病人多的多(per case). 所以在Phoenix有的医生喜欢收无保
险病人. 所以无保险病人不是给高价钱的原因.
to
【在 A*******s 的大作中提到】
: 5800+ 1800.
: $5800 is the bill. insurance may pay 2000, medicare/medicaid may be only
: 1000 or less. The fee is the highest at the biginning of use.
: $1800 for PET reading is excessive indeed. Reimbursement is at most
: 400 or less.
: MRI reading fee is only $100 for commercial insurances, medicare/medicaid
: only pays $50.
: Why bill so much? Non-insured is a big deal for the hospital. That's why I
: posted a thread about ppl who don't buy health insurance. Obamacare has to
: fix these non-insurers, not paid by tax payers but those noninsurer
| C*****D
发帖数: 1299 | 12 叫你读读书再说。美国有立法不能有医生工会。把无知当有趣反复说。
美国医学院只要不太笨肯花钱，基本都能上，大不了去do，carribean schools，再不
济去中国印度东欧读。整天像个怨妇鸡鸡歪歪。
【在 x*****0 的大作中提到】
: 医疗费高的拫源是因为美国医生工会通过限制医生人数, 人为造成医生短缺, 来提高医
: 生工资.
: 关于无保险病人又有医生们想误导不知内情的读者.
: 保险公司和医生及医院有约定价格. 假定约定价格$100,但医生故意开个$500账单忽悠
: 公众好象他们吃了亏. 如果因为某种原因保险公司不付, 病人就惨了. 医生就找病人追
: 的就不是约定的价格$100了, 而是账单上的$500了.
: 因为美国医生知道无保险病人没有negotiation power for price, 理论上医生可以在
: 账单上填任意一个数字,病人只有一个选择, 按账单数字付. MIT 商学院有这方靣研究
: 调查.MIT结论是,尽管有的无保险病人付不出分文, 但对同样的治疗医生从无保险病人
: 得到的钱平均要比有保险病人多的多(per case). 所以在Phoenix有的医生喜欢收无保
| A*******s
发帖数: 9638 | 13 首先， 本版不是谎话说几遍就是真理的地方， 你这种陈词滥调一而再，再而三的发有
意思吗？
你去问问， 有多少人按bill付费的？ 医院的账单都是死账， selfpay就是no pay，
这个道理你要不懂就不要吱声。
【在 x*****0 的大作中提到】
: 医疗费高的拫源是因为美国医生工会通过限制医生人数, 人为造成医生短缺, 来提高医
: 生工资.
: 关于无保险病人又有医生们想误导不知内情的读者.
: 保险公司和医生及医院有约定价格. 假定约定价格$100,但医生故意开个$500账单忽悠
: 公众好象他们吃了亏. 如果因为某种原因保险公司不付, 病人就惨了. 医生就找病人追
: 的就不是约定的价格$100了, 而是账单上的$500了.
: 因为美国医生知道无保险病人没有negotiation power for price, 理论上医生可以在
: 账单上填任意一个数字,病人只有一个选择, 按账单数字付. MIT 商学院有这方靣研究
: 调查.MIT结论是,尽管有的无保险病人付不出分文, 但对同样的治疗医生从无保险病人
: 得到的钱平均要比有保险病人多的多(per case). 所以在Phoenix有的医生喜欢收无保
| L****n
发帖数: 12932 | 14 it 不会是个萝卜吧？ 真是原汁原味啊， 呵呵。
【在 A*******s 的大作中提到】
: 首先， 本版不是谎话说几遍就是真理的地方， 你这种陈词滥调一而再，再而三的发有
: 意思吗？
: 你去问问， 有多少人按bill付费的？ 医院的账单都是死账， selfpay就是no pay，
: 这个道理你要不懂就不要吱声。
| x*****0
发帖数: 101 | 15 你这人当面撒谎, AMA就是美国医生工会.
【在 C*****D 的大作中提到】
: 叫你读读书再说。美国有立法不能有医生工会。把无知当有趣反复说。
: 美国医学院只要不太笨肯花钱，基本都能上，大不了去do，carribean schools，再不
: 济去中国印度东欧读。整天像个怨妇鸡鸡歪歪。
| x*****0
发帖数: 101 | 16 谁告诉你医院账是死账, 是注了氺(数目大大扩大的)账单. 尽管有的无保险病人付不出
分文, 只要有一人付了可以顶好几个正常价格(保险公司价格)的收入.
【在 A*******s 的大作中提到】
: 首先， 本版不是谎话说几遍就是真理的地方， 你这种陈词滥调一而再，再而三的发有
: 意思吗？
: 你去问问， 有多少人按bill付费的？ 医院的账单都是死账， selfpay就是no pay，
: 这个道理你要不懂就不要吱声。
| C*****D
发帖数: 1299 | 17 你听得懂人话吗? AMA 是什么, 几个月前就解释了. 再蠢的人都知道association and union区别。
无知者无畏.
天下能挣钱的活多了去, goldman-sach交易员一年佣金bonus 平均60多万, 只要有本事, 文凭都不要. 抱着不挣钱工作, 怨谁啊?
【在 x*****0 的大作中提到】
: 你这人当面撒谎, AMA就是美国医生工会.
| y*****c
发帖数: 57 | 18 人命太值钱了，很多州都没有cap，多少无良lawyer都虎视眈眈的盯着呢。要是不给人
命定个最高价，医疗改革就是浮云 | P********r
发帖数: 92 | 19 Thank you for the elaboration!
i guess the effort to keep the top status per se doomed the pouring money into
science and tech, then the incorporation of science and tech to clinic---
which drives better and more expensive care.
Sometimes i wonder that we are already at the new height of medicine, why
bother keep pushing forward -- being able to save, say a 20 weeks old fetus,
is a medical breakthrough, but is it worth all the money? Improved medicine
keeps people living way longer, but society wise, is it worth it to spend
without any limit to sustain the life of a 100 year old...
Do personalized medicine and vaccinations really promote better or more
effective health care with logs of more increase in expense, ect...
【在 C*****D 的大作中提到】
: those fancy machines do cost a lot. The hospitals have to pay all indirect
: costs, such as building, utility, supporting personnel etc.
: The bigger the investment, the higher return people wants.
: 在我看来, 美国health care cost 要减下来, 比较渺茫. 现在已进入一个高消费死循
: 环.因为医生和医院都是整个生物医学工业中的一链.
: 如果$5800降一半, 医院要亏, 那就先裁员, 没有利润, 机器就不买, 医疗器械公司就
: 没生意, 不挣钱就切R&D, 码工就失业. 所以器械公司鼓动医院买新机器,医院鼓励医生
: 用贵的tests 和药.
: 医院因为竞争关系也要不停造新大楼, 买最先进机器, 高薪聘能人. 不象中国一个调控
: 就能降下来.
| x*****0
发帖数: 101 | 20 再蠢的人都知道union是工会的功能性称呼, 对某一具体工会不一定用这个词, 也可用
federation, alliance, or association. 如, American Federation of Teachers,
California School Employees Association, National Football League Players
Association. 到底是谁无知者无畏.
goldman-sach交易员的高薪是有问题, 但有一点他们是光明正大的, 他们没有靠人为限
制交易员数量，人为造成交易员短缺来提高工资. 但美国医生工会靠限制医生数量,人
为造成医生短缺来提高医生工资.
and union区别。
事, 文凭都不要. 抱着不挣钱工作, 怨谁啊?
【在 C*****D 的大作中提到】
: 你听得懂人话吗? AMA 是什么, 几个月前就解释了. 再蠢的人都知道association and union区别。
: 无知者无畏.
: 天下能挣钱的活多了去, goldman-sach交易员一年佣金bonus 平均60多万, 只要有本事, 文凭都不要. 抱着不挣钱工作, 怨谁啊?
| M****a
发帖数: 577 | 21 AMA不是工会，要是工会每个医生都要参加的，据说几年前医生一年的会费要$1200，医
生每10年考的board也就这么多钱，所以参加率可想而知。所以AMA更算是一个医生的
advocate group。
不能光看医生收入高这一面，而忽视了美国医生的培养成本（从医学院角度以及医生角
度）。30万美元的债务然后拼上至少7年，就算降低门槛也不是所有人都愿意的。
至于通过缩短培训年限来降低成本，你要是在医院混过就知道了，5分钟内把一个病例
说清楚说透，不花好几年是不可能的，尤其对英语非母语的人来说。
【在 x*****0 的大作中提到】
: 再蠢的人都知道union是工会的功能性称呼, 对某一具体工会不一定用这个词, 也可用
: federation, alliance, or association. 如, American Federation of Teachers,
: California School Employees Association, National Football League Players
: Association. 到底是谁无知者无畏.
: goldman-sach交易员的高薪是有问题, 但有一点他们是光明正大的, 他们没有靠人为限
: 制交易员数量，人为造成交易员短缺来提高工资. 但美国医生工会靠限制医生数量,人
: 为造成医生短缺来提高医生工资.
:
: and union区别。
: 事, 文凭都不要. 抱着不挣钱工作, 怨谁啊?
| C*****D
发帖数: 1299 | 22 please read some basics why physician cann't form nationawide union.
http://www.physiciansnews.com/law/497union.html
【在 x*****0 的大作中提到】
: 再蠢的人都知道union是工会的功能性称呼, 对某一具体工会不一定用这个词, 也可用
: federation, alliance, or association. 如, American Federation of Teachers,
: California School Employees Association, National Football League Players
: Association. 到底是谁无知者无畏.
: goldman-sach交易员的高薪是有问题, 但有一点他们是光明正大的, 他们没有靠人为限
: 制交易员数量，人为造成交易员短缺来提高工资. 但美国医生工会靠限制医生数量,人
: 为造成医生短缺来提高医生工资.
:
: and union区别。
: 事, 文凭都不要. 抱着不挣钱工作, 怨谁啊?
|
|
