‘Cadillac Health Plan Must be a Used Caddy’

To The Editor:
Doc Matlick here, practicing ear, nose, and throat medicine in Atlantic and Cape May counties for the past 26 years. I was shocked the other day when I noted a letter to the editor about us “fat cat” doctors pulling down those big bucks for simple stuff that just about anyone can do.
“Ear cleaning” was a point of contention, and hap-pens to be a specific talent of mine, done under an operating microscope, with great skill and care, occa-sionally restoring as much as 45 percent of a patients’ hearing over the course of a 15-minute visit. My aver-age collection for this service is a mere $59. Addi-tionally, insurers no longer reimburse for “wax re-moval.” Instead it’s included in the office visit as far as Medicare and most carriers are concerned. We do bill some big numbers, just a function of an insurance company game started years ago, but what we bill versus what we are paid is most often as different as apples and oranges.
As an FYI, I average three to four patient visits per hour in my office, no nurse, no physician’s assistant, just me. Last year, I earned under $200/hour gross for my overall effort (patient care and practice administra-tion). My practice, like most, runs at about a 50 per-cent overhead considering the insane cost of admini-stration, personnel, insurance, licenses, dues, supplies, rent, etc. That brings me to an hourly wage not dis-similar to that of other skilled professionals; electri-cians, plumbers, etc. Unlike the less skilled profes-sionals; congressmen, senators, etc., I am not afforded an instant pension after a few years on the job, and my family’s “cadillac” health insurance plan runs about $26,000 per year; that with a $50 co-pay, and $35 Rx drug card…(must be a used ‘Caddy’).
Unlike those on Wall Street or elsewhere in corpo-rate America, I don’t get regular raises for good per-formance (in fact, physician reimbursement is being cut even as I write). That’s “zero” incentive for smarts or performance. With 10 years of post-graduate educa-tion, and 26 years of on-the-job experience, I may recognize a problem simply because I’ve seen it multi-ple times in the past, yet they pay me the same as a they do a “rookie” who may truly spend more time, visits, and studies trying to unravel a diagnosis that may be second nature to a seasoned veteran.
The stress of having to be diagnostically correct 100 percent of the time, and having to have my hands never falter, follows me home nightly, and patient problems ring-up on the phone frequently in off hours as well. As things have become tighter, I lament at not being able to give away as much of my time to those in need, but I’ve never turned away a single patient for lack of the means to pay. By the way, this exemplifies an unintended consequence of the upcoming changes in health care: with more patients and less pay, many docs will be forced to “cherry pick” and take better insurances and/or cash only.
Although more Americans will be afforded access to insurance or Medicaid coverage, they may not be able to locate a participating physician.
Doctors are closing up or picking up and leaving our area. The cost of practice and malpractice insurance makes the profitability of medical practice somewhat prohibitive in this geographic location.
So, can someone please tell me where I can get that $1,000 per hour that was alluded to in that other let-ter to the editor? I’ll happily put in a 40-hour week to net that cool million.
DR. LONNY D. MATLICK
Northfield