Recently, I responded to a thread on the allnurses.com forum where the issues was about patient care vs the business of medicine (my summary). Many nurses and nurse practitioners, as well as other clinicians, do not understand the business of healthcare and how money is indeed the major player. Healthcare is not free, someone is paying for it. And early on, I didn’t understand that.
While working as an RN (and later as an NP) being paid an hourly wage, or even when on salary, I never worried about the overhead cost of seeing patients. Now, as a practice owner, I understand the reality all too well that time truly does equal money. Unfortunately, not everyone understands this reality.
Stop for a moment and consider the overhead (ie, cost to run the business) of any practice, hospital, community clinic. Overhead include (and are not limited to): lease/mortgage; salaries and taxes (often the highest/2nd highest expenditure); utilities (heat/air, water, sewer, garbage); phone and internet access; liability and business insurances; licenses; housekeeping; office supplies; medical supplies; lab costs, including those utilized for POC); billing personnel or billing service (quite high usually); EMR costs; professional services such as the CPA and attorney and a myriad of other costs…before the practice owner ever gets a dime.
Now look at the other side of the equation: a practice owner only makes money when patients are seen (unless you are seeing pts under a capitated plan – which also has it’s limits). There are several ways to look at this: cost per patient, cost per day, break even points.
Let’s look at a simplified example with made up numbers. If the overhead cost per month is $5,000 (this would be a small office), and your average reimbursement is $40.00 (it’s often lower than this for Medicare/Medicaid), then the practice (and often the practice owner) does not make any money until 125 pts are seen that month. However, just because the patients are seen, does not guarantee that the practice will get paid. I am only half joking when I say that insurance companies are not in business to pay your claims.
There are many more variables that go into this, but I write this to give an example of what every practice owner must consider. Nurses and Nurse Practitioners and other clinicians who are employed, we would do well to learn a bit about the business of healthcare.
No one can provide services for free. Even if you volunteered your time entirely, someone has to pay for the cost of providing the service. There is no such thing as free health care. Period. Someone is paying.
And as a professional, don’t you deserve to be paid?
I agree completely. It is why so many medical professionals and now hospitals are moving towards wellness in their practises or facilities. It only makes sense to develop a plan to bring in the community and capture the dollars generated from a solid Wellness program. We now know that medicine and surgery is not always the best solution. and people are more informed. The question is how does the public determine which solutions are best. There are so many companies that are making false claims and the general public is confused. The medical professionals that take time to look at the research and implement good technologies in their practises will have better outcomes and improved finances. I have 14 years as a Wellness Educator.