Thank you, Dr. Bricker, for yet another excellent example of how the health care system works here in the United States. It really is eye opening. I think you are the best thing going on TH-cam. It really alarms me that more and more, patients are seen and treated as a commodity that can be bought and sold on the wholesale market instead of being treated as humans. I've signed up with a Direct Primary Care physician because of this issue.
Agreed! But also curious about the DPC model you brought up. Do you think people (could be you or in general) would consider direct pay model for other specialties beyond primary care? Or would it just be annoying to have the different subscriptions?
@@pransudash1 Yes, there are successful specialty DPC practices. Personally, I would join a specialty practice that I know that I would need on a routine basis, as in dermatology in my case.
I love whiteboard videos. A recent ER visit turned into 3 days of admission. It w The duration of stay was medically justifiable, but it got me thinking about the economics. Over 3 days, we only received 2 CT scans and 1 thoracentesis + two injections of antibiotics and a lot of bloodwork. 1 failed bronchiotemy (the machine died before the procedure could start). That's not a lot of activity for a 3 day stay. It could probably have been done same same day in an efficient system. As a businessperson I was thinking what a poor utilization rate they were achieving, while at the same time manufacturing patient discomfort from all the tossling. This seems like a lose-lose scenario which may be typical (though I suppose they did have an open bed and nurses to fill). The main bottleneck for the stay seemed to be access to the pulmonologist. He was crazy busy. If they'd had a second pulmonologist then perhaps the entire stay might have been minimized. What I was wondering is whether this is purposeful (because hiring another pulmonologist at less than 100% utilization rate would reduce overall ROI) or whether this truly is a supply contained system (they would hire a second doctor if they could, because the ROI, while less, is still positive for any specialist)? Also wondering how much "standard of care" and protocol negatively impact the economics (where economics is but just financial but also quality of experience). In other words, does the hospital system fall flat because of a credo of pursuing "certainty over probability"? And do financial incentives influence that pursuit?
Hi doctor, can you talk about the potential impact of democratic empowering Medicare to negotiate prices directly with drug makers to drug makers? How much of a difference you see from what is it now. Really like your video! Thank you so much. You are the best
Thanks again for yet another insightful video about the incentives underlying care. You've mentioned a few islands in the US healthcare system where health outcome metrics drive business decisions (ex: "advanced" primary care with capitated MA models). It would be interesting to hear your perspective on how we can meaningfully nudge the rest of healthcare towards Dr. Pronovost's approach. How do we get risk-adjusted outcome metrics to drive hospital revenue? Thank you! Sincerely, An IM resident trying to figure out where to work in 2 years time
Thank you for watching. Great question… Vote with your feet. Work at a place that aligns with your beliefs even if that means making less money to start.
J.T. , I am glad you are watching these videos now. All residents should watch them to give the other side of the story the hospital doesn't like to talk about.
Hi Eric: You mention base salary... what about paying for the doc's heathcare (including family), retirement contributions, incentive payments, professional insurance coverage, personal professional growth, etc. How much all rolled in does it cost the hospital for that doc within different categories ? Not just base salary. It annoys me that state university salary rates are provided as an amazing transparency exercise for the taxpayers in the state but non salary is left out (it is a lot for example for business school academics). So., what about your analysis ? Thanks great job.
I want to thank you for your excellent videos. They help break down all of the HC gobbledygook.....haha. I was wondering if you could possibly recommend a good textbook for Healthcare Financial Management. A book that simplifies the major concepts. Something that students can read and actually come away with good knowledge. So many of the textbooks I've come across are very jargony and hard to grasp. Do you have any recommendations Doctor?
Unfortunately, no. That’s part of the reason why I started making these videos. That being said, the book published posthumously by Princeton Economist Uwe Reinhardt is good. I made a video summary of it: th-cam.com/video/Dk0SZUJSibg/w-d-xo.html
Thank you, Dr. Bricker, for yet another excellent example of how the health care system works here in the United States. It really is eye opening. I think you are the best thing going on TH-cam. It really alarms me that more and more, patients are seen and treated as a commodity that can be bought and sold on the wholesale market instead of being treated as humans. I've signed up with a Direct Primary Care physician because of this issue.
Super! Smart move. Thank you for watching and for your kind feedback.
Agreed! But also curious about the DPC model you brought up. Do you think people (could be you or in general) would consider direct pay model for other specialties beyond primary care? Or would it just be annoying to have the different subscriptions?
@@pransudash1 Yes, there are successful specialty DPC practices. Personally, I would join a specialty practice that I know that I would need on a routine basis, as in dermatology in my case.
Thank you for your straightforward explanations. I'm beginning to understand healthcare finances after watching your videos.
Thss as no you for watching.
Powerful and good for you. Finally, a decent human being . I feel like a human ATM at this point.
Sad
Thank you for watching and for your comment.
Family medicine is definitely a key money maker for hospitals that’s being kept a secret
Thank you for sharing your perspective.
I love whiteboard videos.
A recent ER visit turned into 3 days of admission. It w The duration of stay was medically justifiable, but it got me thinking about the economics. Over 3 days, we only received 2 CT scans and 1 thoracentesis + two injections of antibiotics and a lot of bloodwork. 1 failed bronchiotemy (the machine died before the procedure could start). That's not a lot of activity for a 3 day stay. It could probably have been done same same day in an efficient system.
As a businessperson I was thinking what a poor utilization rate they were achieving, while at the same time manufacturing patient discomfort from all the tossling. This seems like a lose-lose scenario which may be typical (though I suppose they did have an open bed and nurses to fill).
The main bottleneck for the stay seemed to be access to the pulmonologist. He was crazy busy. If they'd had a second pulmonologist then perhaps the entire stay might have been minimized.
What I was wondering is whether this is purposeful (because hiring another pulmonologist at less than 100% utilization rate would reduce overall ROI) or whether this truly is a supply contained system (they would hire a second doctor if they could, because the ROI, while less, is still positive for any specialist)?
Also wondering how much "standard of care" and protocol negatively impact the economics (where economics is but just financial but also quality of experience). In other words, does the hospital system fall flat because of a credo of pursuing "certainty over probability"? And do financial incentives influence that pursuit?
Hi doctor, can you talk about the potential impact of democratic empowering Medicare to negotiate prices directly with drug makers to drug makers? How much of a difference you see from what is it now. Really like your video! Thank you so much. You are the best
Good question. I don’t know. Thank you for watching.
Great video!! The focus needs to always be on the Pt. :)
Thank you for watching and for your feedback.
Thanks again for yet another insightful video about the incentives underlying care. You've mentioned a few islands in the US healthcare system where health outcome metrics drive business decisions (ex: "advanced" primary care with capitated MA models). It would be interesting to hear your perspective on how we can meaningfully nudge the rest of healthcare towards Dr. Pronovost's approach. How do we get risk-adjusted outcome metrics to drive hospital revenue? Thank you!
Sincerely,
An IM resident trying to figure out where to work in 2 years time
Thank you for watching. Great question… Vote with your feet.
Work at a place that aligns with your beliefs even if that means making less money to start.
J.T. , I am glad you are watching these videos now. All residents should watch them to give the other side of the story the hospital doesn't like to talk about.
Hi Eric: You mention base salary... what about paying for the doc's heathcare (including family), retirement contributions, incentive payments, professional insurance coverage, personal professional growth, etc. How much all rolled in does it cost the hospital for that doc within different categories ? Not just base salary. It annoys me that state university salary rates are provided as an amazing transparency exercise for the taxpayers in the state but non salary is left out (it is a lot for example for business school academics). So., what about your analysis ? Thanks great job.
Great question. Typically total compensation is salary + about 30% for benefits/insurance/etc.
Thank you for watching.
Another great video
Thank you for watching and for your support.
I want to thank you for your excellent videos. They help break down all of the HC gobbledygook.....haha. I was wondering if you could possibly recommend a good textbook for Healthcare Financial Management. A book that simplifies the major concepts. Something that students can read and actually come away with good knowledge. So many of the textbooks I've come across are very jargony and hard to grasp. Do you have any recommendations Doctor?
Unfortunately, no. That’s part of the reason why I started making these videos.
That being said, the book published posthumously by Princeton Economist Uwe Reinhardt is good. I made a video summary of it: th-cam.com/video/Dk0SZUJSibg/w-d-xo.html