Technology Surcharge --> was RE: email and patients

July 18, 2007

Anyone doing a Technology Surcharge for e-mail access -- especially if you are using a monthly survice with a fee -- i.e. Relay Health?

If it costs $50/month to subscribe to a service to give your patients better access and healthcare -- why should the doctor pay for that out of their own pocket?

Yes, it might save you some time in some ways, but it might take more time in other ways.

Offering this service is sort of like doing a procedure that helps the patient -- we would charge for that procedure wouldn't we?

So, if it is costing $50/month, it will cost $600/year.

If 10% of your patients use the service and you have 500, 1000, 2000 patients, then you would have 50, 100, or 200 patients using the technology.

So you could charge $12, $6, or $3 per year and break even on the cost of the service.

If you had more people using the service, then you could charge less or perhaps it would be a minor profit center.

Say you had 200 patients using the service and charged $10 per year Technology Fee, then you would earn $2,000 per year on the Tech Fee...which should cover the cost of the techology and then some.

Falbal on the AAFP Practice Mgt list charges a Tech Fee I believe.

BTW, I'm always irritated at how the business of medicine has backed themselves into a corner where we can't pass the costs along to a patient.

Gee, our malpractice premiums go up 50%, but we can't raise our fees -- well, you can, but you only get what the insurance will pay.

Gee, the cost of rent goes up 20% -- if I'm a retailer, I raise the cost of my goods, but we can't easily do that.

Anyway, the Tech Fee would seem to be a legitimate way to cover this extra cost of adding e-mail services to a practice and not losing money in the process.

Locke, MDBasalt, COEau (WI) Family Medicine Residency 19945 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB, Germany]Alpine Medical Group -- Private Group Practice since 1999www.alpinemedical.mdJob Share w/ WifeAMG went independent from hospital MSO 10/04AMG implemented Centricity EMR April 2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family Medicine 18 August 2007

www.LockeFamilyMedicine.com

July 18, 2007

I think you make some good points, especially about medicine not passing (being able

to pass) costs to the " customers " . I think of my McKesson invoices'

" fuel surcharge " that was added when oil prices skyrocketed a year ago --

now, a year later, more than enough time to budget costs of overhead, but the

" fuel surcharge " is still on the bills (!).Certainly some of

us do have a fee of one kind or another for such services. I however chose not

to go that course. My thinking is that my tech systems are a fraction of the

cost of having staff but allow me to do the work of the staff (I'm solo-solo

remember). So I look at it as my " micro-staff " costs. Plus I

use the communications as both a quality method (follow up " how did it

go? " questions) and triage (pt often has given most of the history on the email

for an acute visit).I look forward to learning how others chose to, or

not to, have such a fee.TimOn Wed, July

18, 2007 11:48 am EDT, Locke's in Colorado wrote:

Anyone doing a

Technology Surcharge for e-mail access -- especially if you are using a

monthly survice with a fee -- i.e. Relay Health?

If it costs $50/month to subscribe to a service to give your patients better access and healthcare -- why should the doctor pay for that out of their own pocket?

Yes, it might

save you some time in some ways, but it might take more time in other ways.

Offering this

service is sort of like doing a procedure that helps the patient -- we would

charge for that procedure wouldn't we?

So, if it is

costing $50/month, it will cost $600/year.

If 10% of your

patients use the service and you have 500, 1000, 2000 patients, then you would

have 50, 100, or 200 patients using the technology.

So you could

charge $12, $6, or $3 per year and break even on the cost of the service.

If you had more

people using the service, then you could charge less or perhaps it would be a

minor profit center.

Say you had 200

patients using the service and charged $10 per year Technology Fee, then you

would earn $2,000 per year on the Tech Fee...which should cover the cost of

the techology and then some.

Falbal on the

AAFP Practice Mgt list charges a Tech Fee I believe.

BTW, I'm always

irritated at how the business of medicine has backed themselves into a corner

where we can't pass the costs along to a patient.

Gee, our malpractice premiums go up 50%, but we can't raise our fees -- well, you can, but you only get what the insurance will pay.

Gee, the cost

of rent goes up 20% -- if I'm a retailer, I raise the cost of my goods, but we

can't easily do that.

Anyway, the

Tech Fee would seem to be a legitimate way to cover this extra cost of adding

e-mail services to a practice and not losing money in the

process.

Locke, MDBasalt, COEau

(WI) Family Medicine Residency 19945 Years in Air Force -- [Laughlin AFB

(Del Rio, TX) // Spangdahlem AB, Germany]Alpine Medical Group -- Private

Group Practice since 1999www.alpinemedical.mdJob Share w/ WifeAMG went independent from hospital MSO 10/04AMG implemented Centricity

EMR April 2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family

Medicine 18 August 2007

www.LockeFamilyMedicine.com

---------------------------------------- Malia, MD Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 (phone /

fax) www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including all the

attachments, is for the sole use of the intended recipient(s) and contains

confidential information. Unauthorized use or disclosure is prohibited. If you are

not the intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the sender

immediately by reply email and destroy all copies of the original message, including

attachments. ----------------------------------------

---------------------------------------- Malia, MD Malia Family Medicine

& Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY

14450 (phone / fax) www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including

all the attachments, is for the sole use of the intended recipient(s) and contains

confidential information. Unauthorized use or disclosure is prohibited. If you are

not the intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the sender

immediately by reply email and destroy all copies of the original message, including

attachments. ----------------------------------------

July 19, 2007

I think it is one thing to pursue e visits as Eads does

but

E mail saves me money paper time stamps mailing it all cost more than

email I must say

AS to Alan Falkoff in Connecticut

his mode of practice is the antithesis of what we do here.

At aafp last year he prowlled teh vendors he told me to see what he could

buy as a gadget to bill patietns a service for to ge t more money He also

works inteh richest part of the richest state so there are many reason

s esp appraoch to care that he is no example to follow

Re: Technology Surcharge --> was RE: email

and patients

I think you make some good points, especially about medicine not passing

(being able to pass) costs to the " customers " . I think of my McKesson

invoices' " fuel surcharge " that was added when oil prices skyrocketed a

year ago -- now, a year later, more than enough time to budget costs of

overhead, but the " fuel surcharge " is still on the bills (!).

Certainly some of us do have a fee of one kind or another for such

services. I however chose not to go that course. My thinking is that

my tech systems are a fraction of the cost of having staff but allow me

to do the work of the staff (I'm solo-solo remember). So I look at it

as my " micro-staff " costs. Plus I use the communications as both a

quality method (follow up " how did it go? " questions) and triage (pt

often has given most of the history on the email for an acute visit).

I look forward to learning how others chose to, or not to, have such a

fee.

Tim

On Wed, July 18, 2007 11:48 am EDT, Locke's in Colorado wrote:

Anyone doing a

Technology Surcharge for e-mail access -- especially if you are using a

monthly

survice with a fee -- i.e. Relay Health?

If it costs

$50/month to subscribe to a service to give your patients better access

and

healthcare -- why should the doctor pay for that out of their own

pocket?

Yes, it might

save you some time in some ways, but it might take more time in other

ways.

Offering this

service is sort of like doing a procedure that helps the patient -- we

would

charge for that procedure wouldn't we?

So, if it is

costing $50/month, it will cost $600/year.

If 10% of your

patients use the service and you have 500, 1000, 2000 patients, then you

would

have 50, 100, or 200 patients using the technology.

So you could

charge $12, $6, or $3 per year and break even on the cost of the

service.

If you had more

people using the service, then you could charge less or perhaps it would

be a

minor profit center.

Say you had 200

patients using the service and charged $10 per year Technology Fee, then

you

would earn $2,000 per year on the Tech Fee...which should cover the cost

of the

techology and then some.

Falbal on the

AAFP Practice Mgt list charges a Tech Fee I believe.

BTW, I'm always

irritated at how the business of medicine has backed themselves into a

corner

where we can't pass the costs along to a patient.

Gee, our

malpractice premiums go up 50%, but we can't raise our fees -- well, you

can,

but you only get what the insurance will pay.

Gee, the cost of

rent goes up 20% -- if I'm a retailer, I raise the cost of my goods, but

we

can't easily do that.

Anyway, the Tech

Fee would seem to be a legitimate way to cover this extra cost of adding

e-mail

services to a practice and not losing money in the process.

Locke, MD

Basalt, CO

Eau (WI)

Family Medicine Residency 1994

5 Years in Air Force -- [Laughlin AFB (Del

Rio, TX) // Spangdahlem AB, Germany]

Alpine Medical Group -- Private Group

Practice since 1999

<http://www.alpinemedical.md/> www.alpinemedical.md

Job Share w/ Wife

AMG

went independent from hospital MSO 10/04

AMG implemented Centricity EMR April

2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family

Medicine 18 August 2007

www.LockeFamilyMedi <http://www.lockefamilymedicine.com/> cine.com

----------------------------------------

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use

of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the

intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

----------------------------------------

---------------------------------------- Malia, MD Malia Family

Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square

Mall Fairport, NY 14450 (phone / fax)

www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com --

Confidentiality Notice -- This email message, including all the

attachments, is for the sole use of the intended recipient(s) and

contains confidential information. Unauthorized use or disclosure is

prohibited. If you are not the intended recipient, you may not use,

disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email

and destroy all copies of the original message, including attachments.

----------------------------------------

July 19, 2007

I understand your point, but I'm talking about more than just using

Outlook e-mail to contact patients.

If one is just using regular non-secure e-mail, I could see the argument of

not charging.

But if one is using secure e-mail that costs $25-50/month to maintain, why

not pass that cost on to the patient.

Every other business out there passes expenses on to the patient, why

wouldn't we.

Even if it saves me time, decreases paper costs, gives better care, etc...if

it costs my bottom line money and I can pass that cost to the patient, why

wouldn't I?

Cheers

Locke

Re: Technology Surcharge --> was RE: email

and patients

I think you make some good points, especially about medicine not passing

(being able to pass) costs to the " customers " . I think of my McKesson

invoices' " fuel surcharge " that was added when oil prices skyrocketed a year

ago -- now, a year later, more than enough time to budget costs of overhead,

but the " fuel surcharge " is still on the bills (!).

Certainly some of us do have a fee of one kind or another for such services.

I however chose not to go that course. My thinking is that my tech systems

are a fraction of the cost of having staff but allow me to do the work of

the staff (I'm solo-solo remember). So I look at it as my " micro-staff "

costs. Plus I use the communications as both a quality method (follow up

" how did it go? " questions) and triage (pt often has given most of the

history on the email for an acute visit).

I look forward to learning how others chose to, or not to, have such a fee.

Tim

On Wed, July 18, 2007 11:48 am EDT, Locke's in Colorado wrote:

Anyone doing a

Technology Surcharge for e-mail access -- especially if you are using a

monthly survice with a fee -- i.e. Relay Health?

If it costs

$50/month to subscribe to a service to give your patients better access and

healthcare -- why should the doctor pay for that out of their own pocket?

Yes, it might

save you some time in some ways, but it might take more time in other ways.

Offering this

service is sort of like doing a procedure that helps the patient -- we would

charge for that procedure wouldn't we?

So, if it is

costing $50/month, it will cost $600/year.

If 10% of your

patients use the service and you have 500, 1000, 2000 patients, then you

would

have 50, 100, or 200 patients using the technology.

So you could

charge $12, $6, or $3 per year and break even on the cost of the

service.

If you had more

people using the service, then you could charge less or perhaps it would

be a

minor profit center.

Say you had 200

patients using the service and charged $10 per year Technology Fee, then

you

would earn $2,000 per year on the Tech Fee...which should cover the cost

of the

techology and then some.

Falbal on the

AAFP Practice Mgt list charges a Tech Fee I believe.

BTW, I'm always

irritated at how the business of medicine has backed themselves into a

corner

where we can't pass the costs along to a patient.

Gee, our

malpractice premiums go up 50%, but we can't raise our fees -- well, you

can,

but you only get what the insurance will pay.

Gee, the cost of

rent goes up 20% -- if I'm a retailer, I raise the cost of my goods, but

we

can't easily do that.

Anyway, the Tech

Fee would seem to be a legitimate way to cover this extra cost of adding

e-mail

services to a practice and not losing money in the process.

Locke, MD

Basalt, CO

Eau (WI)

Family Medicine Residency 1994

5 Years in Air Force -- [Laughlin AFB (Del

Rio, TX) // Spangdahlem AB, Germany]

Alpine Medical Group -- Private Group

Practice since 1999

<http://www.alpinemedical.md/> www.alpinemedical.md

Job Share w/ Wife

AMG

went independent from hospital MSO 10/04

AMG implemented Centricity EMR April

2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family

Medicine 18 August 2007

www.LockeFamilyMedi <http://www.lockefamilymedicine.com/> cine.com

----------------------------------------

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use

of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the

intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

----------------------------------------

---------------------------------------- Malia, MD Malia Family

Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square

Mall Fairport, NY 14450 (phone / fax)

www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com --

Confidentiality Notice -- This email message, including all the

attachments, is for the sole use of the intended recipient(s) and

contains confidential information. Unauthorized use or disclosure is

prohibited. If you are not the intended recipient, you may not use,

disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email

and destroy all copies of the original message, including attachments.

----------------------------------------

July 19, 2007

Now that I think about it...

Another angle/reason for NOT charging patients for an e-mail service that

costs the practice money would be that it might be a marketing strategy.

You could increase your patient #'s by offering e-mail when the practice

down the street doesn't.

So it might be a practice builder in some sense.

But if your practice is mature, then offering this service for free is

basically just adding overhead to your practice -- yes, possibly improving

care, too, but we are still taking home less money at the end of the day.

Just another thought.

Locke

Re: Technology Surcharge --> was RE: email

and patients

I think you make some good points, especially about medicine not passing

(being able to pass) costs to the " customers " . I think of my McKesson

invoices' " fuel surcharge " that was added when oil prices skyrocketed a year

ago -- now, a year later, more than enough time to budget costs of overhead,

but the " fuel surcharge " is still on the bills (!).

Certainly some of us do have a fee of one kind or another for such services.

I however chose not to go that course. My thinking is that my tech systems

are a fraction of the cost of having staff but allow me to do the work of

the staff (I'm solo-solo remember). So I look at it as my " micro-staff "

costs. Plus I use the communications as both a quality method (follow up

" how did it go? " questions) and triage (pt often has given most of the

history on the email for an acute visit).

I look forward to learning how others chose to, or not to, have such a fee.

Tim

On Wed, July 18, 2007 11:48 am EDT, Locke's in Colorado wrote:

Anyone doing a

Technology Surcharge for e-mail access -- especially if you are using a

monthly survice with a fee -- i.e. Relay Health?

If it costs

$50/month to subscribe to a service to give your patients better access and

healthcare -- why should the doctor pay for that out of their own pocket?

Yes, it might

save you some time in some ways, but it might take more time in other ways.

Offering this

service is sort of like doing a procedure that helps the patient -- we would

charge for that procedure wouldn't we?

So, if it is

costing $50/month, it will cost $600/year.

If 10% of your

patients use the service and you have 500, 1000, 2000 patients, then you

would have 50, 100, or 200 patients using the technology.

So you could

charge $12, $6, or $3 per year and break even on the cost of the service.

If you had more

people using the service, then you could charge less or perhaps it would be

a minor profit center.

Say you had 200

patients using the service and charged $10 per year Technology Fee, then you

would earn $2,000 per year on the Tech Fee...which should cover the cost of

the techology and then some.

Falbal on the

AAFP Practice Mgt list charges a Tech Fee I believe.

BTW, I'm always

irritated at how the business of medicine has backed themselves into a

corner

where we can't pass the costs along to a patient.

Gee, our

malpractice premiums go up 50%, but we can't raise our fees -- well, you

can,

but you only get what the insurance will pay.

Gee, the cost of

rent goes up 20% -- if I'm a retailer, I raise the cost of my goods, but

we

can't easily do that.

Anyway, the Tech

Fee would seem to be a legitimate way to cover this extra cost of adding

e-mail

services to a practice and not losing money in the process.

Locke, MD

Basalt, CO

Eau (WI)

Family Medicine Residency 1994

5 Years in Air Force -- [Laughlin AFB (Del

Rio, TX) // Spangdahlem AB, Germany]

Alpine Medical Group -- Private Group

Practice since 1999

<http://www.alpinemedical.md/> www.alpinemedical.md

Job Share w/ Wife

AMG

went independent from hospital MSO 10/04

AMG implemented Centricity EMR April

2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family

Medicine 18 August 2007

www.LockeFamilyMedi <http://www.lockefamilymedicine.com/> cine.com

----------------------------------------

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use

of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the

intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

----------------------------------------

---------------------------------------- Malia, MD Malia Family

Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square

Mall Fairport, NY 14450 (phone / fax)

www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com --

Confidentiality Notice -- This email message, including all the

attachments, is for the sole use of the intended recipient(s) and

contains confidential information. Unauthorized use or disclosure is

prohibited. If you are not the intended recipient, you may not use,

disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email

and destroy all copies of the original message, including attachments.

----------------------------------------

July 19, 2007

Went to a Focus group at our local

hospital last evening. They are re-structuring medical staff with a new

position: “community physician representative”. This position is

held by local FP whose task it is to find ways the hospital can help the

community physicians stay in the community (read between the lines: stay in

business). I have to believe the powers at the hospital really have our best

interest at heart, but do wonder “what is in it for them”. HOWEVER,

things are pretty bad in the state of land: lowest 22% in re-imbursement

nation wide, cost of running practice is 108% higher than national average,

malpractice rates only temporarily stabilized 2 years ago…goes away in

January 2008 (rates were to nearly double and last minute legislation kicked in

to help out but the $ has run out…)…AND the president of state

chapter of AAFP just resigned to take a position as a hospice director in

another state…citing poor physician re-imbursement as primary reason for

her departure.

SO, to not stray too far from the subject

line: at this meeting, a local internist told us he is out $250,000 b/c he

tried to pass on costs of increasing malpractice (about 2 years ago) to his

patients with a “voluntary

contribution to offset high cost of malpractice”…(I think it was

$50). Turns out his document was waved in front of state attorney general and

legal fees have since amounted to the 250K!! Moral of the story is: be

careful what you ask the patients to pay for, even when it seems fair, “right”

and VOLUNTARY!

It is a bit scary here in the mid-Atlantic…

(where the blues are reported to pay $90 on a 99215) …and I am still

trying to hold on to the idea that patients will come to my “cash-only”

practice, eventually! Could be one of those “dead zones”…I’ll

keep you posted!

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

410 349-2250

polis, MD

From: [mailto: ] On Behalf Of Locke's in Colorado

Sent: Wednesday, July 18, 2007

11:49 AM

To:

Subject: Technology Surcharge

--> was RE: email and patients

Anyone doing a Technology Surcharge for

e-mail access -- especially if you are using a monthly survice with a fee --

i.e. Relay Health?

If it costs $50/month to subscribe to a

service to give your patients better access and healthcare -- why should the

doctor pay for that out of their own pocket?

Yes, it might save you some time in some

ways, but it might take more time in other ways.

Offering this service is sort of like doing

a procedure that helps the patient -- we would charge for that procedure

wouldn't we?

So, if it is costing $50/month, it will

cost $600/year.

If 10% of your patients use the service and

you have 500, 1000, 2000 patients, then you would have 50, 100, or 200 patients

using the technology.

So you could charge $12, $6, or $3 per year

and break even on the cost of the service.

If you had more people using the service,

then you could charge less or perhaps it would be a minor profit center.

Say you had 200 patients using the service

and charged $10 per year Technology Fee, then you would earn $2,000 per year on

the Tech Fee...which should cover the cost of the techology and then some.

Falbal on the AAFP Practice Mgt list

charges a Tech Fee I believe.

BTW, I'm always irritated at how the business

of medicine has backed themselves into a corner where we can't pass the costs

along to a patient.

Gee, our malpractice premiums go up 50%,

but we can't raise our fees -- well, you can, but you only get what the

insurance will pay.

Gee, the cost of rent goes up 20% -- if I'm

a retailer, I raise the cost of my goods, but we can't easily do that.

Anyway, the Tech Fee would seem to be a

legitimate way to cover this extra cost of adding e-mail services to a practice

and not losing money in the process.

Locke, MD

Basalt, CO

Eau (WI)

Family Medicine Residency 1994

5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem

AB, Germany]

Alpine Medical Group -- Private Group Practice since 1999

www.alpinemedical.md

Job Share w/ Wife

AMG went independent from hospital MSO 10/04

AMG implemented Centricity EMR April 2005

AMG is dissolving 17 August 2007

& Locke plan to set up Locke Family Medicine 18 August

2007

www.LockeFamilyMedicine.com

July 19, 2007

RE confrontation on tech surcharge -- Falball at FPM listserv states Connecticut attorney general had challenged his but didn't take action.

I too feel that a "subscription practice" is a tough risk to handle.

In PA, financial risk is mounting too.

My longterm goal is 2 pts/hour, @15 pts/day. Need FTE 1.5 to support this (yes yes I know some hate that) but I'll survive that (wife also gives 1.0 FTE as well.

Dr Matt Levin

east of Pittsburgh, PA

Solo since Dec 2004

RE: Technology Surcharge --> was RE: email and patients

Went to a Focus group at our local hospital last evening. They are re-structuring medical staff with a new position: “community physician representative”. This position is held by local FP whose task it is to find ways the hospital can help the community physicians stay in the community (read between the lines: stay in business). I have to believe the powers at the hospital really have our best interest at heart, but do wonder “what is in it for them”. HOWEVER, things are pretty bad in the state of land: lowest 22% in re-imbursement nation wide, cost of running practice is 108% higher than national average, malpractice rates only temporarily stabilized 2 years ago…goes away in January 2008 (rates were to nearly double and last minute legislation kicked in to help out but the $ has run out…)…AND the president of state chapter of AAFP just resigned to take a position as a hospice director in another state…citing poor physician re-imbursement as primary reason for her departure.

SO, to not stray too far from the subject line: at this meeting, a local internist told us he is out $250,000 b/c he tried to pass on costs of increasing malpractice (about 2 years ago) to his patients with a “voluntary contribution to offset high cost of malpractice”…(I think it was $50). Turns out his document was waved in front of state attorney general and legal fees have since amounted to the 250K!! Moral of the story is: be careful what you ask the patients to pay for, even when it seems fair, “right” and VOLUNTARY!

It is a bit scary here in the mid-Atlantic… (where the blues are reported to pay $90 on a 99215) …and I am still trying to hold on to the idea that patients will come to my “cash-only” practice, eventually! Could be one of those “dead zones”…I’ll keep you posted!

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

410 349-2250

polis, MD

From: [mailto: ] On Behalf Of Locke's in ColoradoSent: Wednesday, July 18, 2007 11:49 AMTo: Subject: Technology Surcharge --> was RE: email and patients