I work right next door to a family doctor and I am not sure he likes the capitation agreements he has (I am pretty sure he is exiting a major one right now).
I think the problem is the reimbursement has a ceiling on it and overhead rises, but reimbursement doesn't. I think the low copays that go with primary care (specialists are always higher) actually hits him psychologically as DisneySteve notes.
It's hard when people come in with $5 copays and you end up with $100.00 at the end of the day to show for your work and you have a staff of 10 working under you. Even if he is paid $4000/month, there's something irresponsible about a patient handing over $5.00 and a Blue Cross Card to a doctor and saying,
"Good luck. I hope you get paid."
I'm in the specialist realm (or maybe considered "other") so I don't have that. I am just relaying the thoughts of one family doctor.
I can tell overhead is a huge issue with him as he underpays his staff ($8-9/hour) who work like the Dickens for him.
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