Karen Nash is a medical reporter and media consultant based in Monroeville, PA.
"Becoming a member of the larger group has given us more bargaining power in the health care marketplace, so we’ve been able to get better health care, not only for us but for our staff," says one urologist.
Urology Times reached out to three urologists (selected randomly) and asked them each the following question: How have your benefits changed over the past several years?
"We’ve had changes in the past year, basically because we were a smaller, single-specialty group, and we joined a larger, multispecialty group last January. As a small group, we had little leverage for negotiating things like health care for the five physicians in our group and staff of 30.
Becoming a member of the larger group has given us more bargaining power in the health care marketplace, so we’ve been able to get better health care, not only for us but for our staff. It’s given us better 401(k)s for retirement and better vacation because we have more support. We don’t come back to work just to have to work harder to pay for the overhead that continued to accumulate while we were gone. Instead of paying for continuing medical education out of my own pocket, it now comes out of the group’s budget.
Also from Karen Nash: What’s your opinion of Medicare for All?
I was in the single-specialty group for 12 years, and it’s not that we couldn’t adjust things to increase benefits, but we were doing it from a very small pool. Now we’re working with a bigger pool.
That was a huge part of the benefit of joining a large, multispecialty group.”
Meredith Baker, MD / Bend, OR
Next:"We’ve been able to maintain our benefits, but the cost of doing it has gone up for sure, especially health insurance."“I’m in a large single-specialty group with 28 urologists. We’ve been able to maintain our benefits, but the cost of doing it has gone up for sure, especially health insurance. That’s a big issue. It’s probably what we’ve had to work hardest to manage.
In terms of 401(k)s, we’ve been able to maintain those but have had to shop around to find savings in administrative fees for those plans. We’ve made some adjustments, changing providers. In terms of providing vacation, we still do those at the same level we’ve always done, but we realize that, because overhead keeps going up, the cost of doing those things has also gone up. We have to work more hours to get the same amount of vacation.
The way CME works, since we’re basically our own bosses, every doctor has a different approach of how to spend on CME, so at the end of the year, CME comes out of each individual’s account balance.
Everything’s done in house. So we do have to keep looking for different health insurance companies or different benefits providers-not actually us-but our administrators have to, as overhead costs continue to rise.
There’s always the temptation to go with a hospital; not that we ever had any concrete plans, but we’ve seen other specialists do it. There are benefits to not having to deal with the headaches of keeping up with costs. In exchange, however, you give up your independence. For us that’s pretty important, so we haven’t really looked at it seriously.
We’re not expanding benefits, just trying to maintain what we’ve always had, and we’ve chosen to accept the bill for those because they’re important to us.”
Gerald Park, MD / North Kansas City, MO
Next: “I’m hospital based, and we haven’t seen any change in our benefits over the years."“I’m hospital based, and we haven’t seen any change in our benefits over the years. Our retirement plans are the same. They’ve become more vigilant about CME expenses, with more travel policies and more hoops to jump through. They’re always watching when you’re spending money.
The vacation issue doesn’t apply to me because I was grandfathered in, but doctors receiving offers today are getting less vacation than they would have before. There’s a one-policy-fits-all approach where I work, so they don’t offer any more vacation to recruit a new physician just because there is a shortage of urologists.
The benefits have not gotten more generous, that’s for sure, but all the standard benefits have stayed pretty much the same over the years, including our health insurance.
We were a private group for most of my career and became hospital based in 2013. It was becoming more and more difficult to exist in private practice. Expenses were up and reimbursements had plummeted.
The big difference is that salaries are generally higher. There’s more of a move toward reimbursing call, being employed compared to being in private practice. In working for a hospital, we don’t have to deal with managing human resources or things like insurance and retirement; we don’t have those headaches.
They’re a corporation and they’re always looking for ways to save a bit of money. So, we don’t get better benefits, but that’s kind of offset by the fact that our salaries are a bit higher if you’re hospital employed than if you’re in private practice nowadays.”
John Lyne, MD / Grove City, PA
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