Doctors’ pay involves a lot of unseen work

 

“Doctors make a lot of money.” We hear that a lot, always from people who aren’t part of the profession.

Last month, I had to do my tax forms. Not my annual forms, but the quarterly withholding ones for the IRS, and for the state, along with the Arizona Department of Economic Security forms.

My bank prints out the forms for me to sign, but being compulsive, I want to run the numbers myself. So I sit down, tally things up on paper, make sure the numbers all match, then send the forms in. Sometimes, I discover mistakes here or there, so have to pick through the previous quarter’s payroll to find out where I went wrong and how to correct it.

The whole thing takes me about 2 hours every 3 months. I suppose I could hire an accountant or office manager to deal with that stuff, but in solo practice, you do everything you can to keep the overhead low. So I do it myself.

Eight hours a year doesn’t sound too bad, but it got me thinking about all the other ways that work creeps into my home time.

I’m usually at the office around 5:00 a.m., when I start with reviewing charts, doing paperwork, and catching up on dictations until patients start at 8:00 a.m. From then on, they’re a steady stream until 4:00 p.m., when we close up and head home.

I get home and then have 1-2 hours of time paying bills, sorting mail, and catching up on phone calls and other unresolved issues.

 

On weekends, there’s always other stuff. Payroll for the coming weeks, office bills, and credit card statements I didn’t get to during the week, CME, forms, licensing paperwork, etc.

I’d guess about 15 hours/week goes into nonpatient-related stuff. Each year that’s more than 700 hours (or a little over a month) of extra time. Tack that on to the roughly 60 hours that I spend seeing patients between the office and hospital.

People say we make “a lot” (whatever that is), but they don’t see everything behind it. The 7-12 years of post-college training. The student loans of $200,000 and dating back to when I was 26 years old. The rising costs of overhead and dropping rates of reimbursement. The denied payments in disputes over claims. And, as mentioned above, the huge amount of time this job takes for stuff beyond just seeing patients.

We don’t get paid by the hour, but if we did, the rate would probably be a lot lower than what most would expect.

 

I suppose I could become employed, and let someone else worry about those things. But the financial impact doesn’t go away. Someone else still has to be doing those things, and since doctors are the ones who generate income in the majority of medical practices, the salaries for everyone else come out of ours. Plus, as I’ve previously written about, I’ve been employed before and got sick of the meetings and memos about cost-sharing, productivity numbers, and dollars earned per square foot.

But whenever I hear the refrain about our field being overpaid, I think about the actual hours the public doesn’t see (or care about). This isn’t a job for slackers, and most of us work long hours to make ends meet. It’s a side of being a doctor that’s rarely, if ever, seen outside the field.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

 

“Doctors make a lot of money.” We hear that a lot, always from people who aren’t part of the profession.

Last month, I had to do my tax forms. Not my annual forms, but the quarterly withholding ones for the IRS, and for the state, along with the Arizona Department of Economic Security forms.

My bank prints out the forms for me to sign, but being compulsive, I want to run the numbers myself. So I sit down, tally things up on paper, make sure the numbers all match, then send the forms in. Sometimes, I discover mistakes here or there, so have to pick through the previous quarter’s payroll to find out where I went wrong and how to correct it.

The whole thing takes me about 2 hours every 3 months. I suppose I could hire an accountant or office manager to deal with that stuff, but in solo practice, you do everything you can to keep the overhead low. So I do it myself.

Eight hours a year doesn’t sound too bad, but it got me thinking about all the other ways that work creeps into my home time.

I’m usually at the office around 5:00 a.m., when I start with reviewing charts, doing paperwork, and catching up on dictations until patients start at 8:00 a.m. From then on, they’re a steady stream until 4:00 p.m., when we close up and head home.

I get home and then have 1-2 hours of time paying bills, sorting mail, and catching up on phone calls and other unresolved issues.

 

On weekends, there’s always other stuff. Payroll for the coming weeks, office bills, and credit card statements I didn’t get to during the week, CME, forms, licensing paperwork, etc.

I’d guess about 15 hours/week goes into nonpatient-related stuff. Each year that’s more than 700 hours (or a little over a month) of extra time. Tack that on to the roughly 60 hours that I spend seeing patients between the office and hospital.

People say we make “a lot” (whatever that is), but they don’t see everything behind it. The 7-12 years of post-college training. The student loans of $200,000 and dating back to when I was 26 years old. The rising costs of overhead and dropping rates of reimbursement. The denied payments in disputes over claims. And, as mentioned above, the huge amount of time this job takes for stuff beyond just seeing patients.

We don’t get paid by the hour, but if we did, the rate would probably be a lot lower than what most would expect.

 

I suppose I could become employed, and let someone else worry about those things. But the financial impact doesn’t go away. Someone else still has to be doing those things, and since doctors are the ones who generate income in the majority of medical practices, the salaries for everyone else come out of ours. Plus, as I’ve previously written about, I’ve been employed before and got sick of the meetings and memos about cost-sharing, productivity numbers, and dollars earned per square foot.

But whenever I hear the refrain about our field being overpaid, I think about the actual hours the public doesn’t see (or care about). This isn’t a job for slackers, and most of us work long hours to make ends meet. It’s a side of being a doctor that’s rarely, if ever, seen outside the field.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

 

“Doctors make a lot of money.” We hear that a lot, always from people who aren’t part of the profession.

Last month, I had to do my tax forms. Not my annual forms, but the quarterly withholding ones for the IRS, and for the state, along with the Arizona Department of Economic Security forms.

My bank prints out the forms for me to sign, but being compulsive, I want to run the numbers myself. So I sit down, tally things up on paper, make sure the numbers all match, then send the forms in. Sometimes, I discover mistakes here or there, so have to pick through the previous quarter’s payroll to find out where I went wrong and how to correct it.

The whole thing takes me about 2 hours every 3 months. I suppose I could hire an accountant or office manager to deal with that stuff, but in solo practice, you do everything you can to keep the overhead low. So I do it myself.

Eight hours a year doesn’t sound too bad, but it got me thinking about all the other ways that work creeps into my home time.

I’m usually at the office around 5:00 a.m., when I start with reviewing charts, doing paperwork, and catching up on dictations until patients start at 8:00 a.m. From then on, they’re a steady stream until 4:00 p.m., when we close up and head home.

I get home and then have 1-2 hours of time paying bills, sorting mail, and catching up on phone calls and other unresolved issues.

 

On weekends, there’s always other stuff. Payroll for the coming weeks, office bills, and credit card statements I didn’t get to during the week, CME, forms, licensing paperwork, etc.

I’d guess about 15 hours/week goes into nonpatient-related stuff. Each year that’s more than 700 hours (or a little over a month) of extra time. Tack that on to the roughly 60 hours that I spend seeing patients between the office and hospital.

People say we make “a lot” (whatever that is), but they don’t see everything behind it. The 7-12 years of post-college training. The student loans of $200,000 and dating back to when I was 26 years old. The rising costs of overhead and dropping rates of reimbursement. The denied payments in disputes over claims. And, as mentioned above, the huge amount of time this job takes for stuff beyond just seeing patients.

We don’t get paid by the hour, but if we did, the rate would probably be a lot lower than what most would expect.

 

I suppose I could become employed, and let someone else worry about those things. But the financial impact doesn’t go away. Someone else still has to be doing those things, and since doctors are the ones who generate income in the majority of medical practices, the salaries for everyone else come out of ours. Plus, as I’ve previously written about, I’ve been employed before and got sick of the meetings and memos about cost-sharing, productivity numbers, and dollars earned per square foot.

But whenever I hear the refrain about our field being overpaid, I think about the actual hours the public doesn’t see (or care about). This isn’t a job for slackers, and most of us work long hours to make ends meet. It’s a side of being a doctor that’s rarely, if ever, seen outside the field.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.