The Best- And Worst-Paying Jobs For Doctors – Dr. Kordonowy’s commentary-07/24/2011

Raymond Kordonowy comments on a recent article in Forbes concerning the shortage of primary care physicians stemming from the pay disparity between specialists and primary care, “The Best- And Worst-Paying Jobs For Doctors”.

“On physician payment. The system of payment for physicians has become pegged to the Medicare fee schedule. In appx 1993 Medicare’s program stopped allowing physicians to bill above the allowed fee schedule for covered services (virtually everything is codified). When the RVU system was designed, office evaluations were assigned some of the lowest reimbursements. High tech stuff and procedures got paid more generously (and most likely they should have). The disparity in physician pay is a result of nearly 2 decades of price fixing which now involves all payers. Office evaluation has gotten much more complex and burdensome but the RVU system hasn’t made the proper accounting. Furthermore the demand side of this equation (magnified immensely due to minimal out of pocket per visit costs) has outstripped the supply side (primary physician availability and new trainees is at all time low). As long as we don’t allow a true pricing mechanism for health care services we will continue to see very lopsided earning potentials,unsatisfied customers and dissatisfied providers (in some cases). Overpayment of some fixed prices will drive overuse and underpayment will result in loss of services. Low pay will translate to a loss of that type of provider. This is very poor economics applied real world in the good ole US of A. It is no surprise to me as a provider that the country continues to be choking over what it is paying for health care- the model of payment is predictably flawed. The latest nonsense of ACO’s and shared cost risk will make it even worse.”

About thedoctorsreport

Dr. Kordonowy is board certified by the American Board of Internal Medicine and has been in private practice since 1993. His group practice is in Fort Myers, Florida. His website is: He earned his degree from the University of Kansas School of Medicine in Kansas City, Kansas and completed his residency as Chief Resident at Orlando Regional Hospital System. As Chief Resident, Dr. Kordonowy was recognized as the Outstanding Resident by the American College of Physicians. He is a member of the American Medical Association, American College of Physicians, and the American Society of Internal Medicine. In December 2005, Dr. Kordonowy became Board Certified in the new field of Clinical Lipidology by the American Board of Clinical Lipidology. Lipidology is the specialty of diagnosis and management of cholesterol and triglyceride metabolism disorders. Cardiovascular disease risk assessment is also part of this specialty. He now serves as president of the Independent Physicians Association of Lee County. He is active in the Lee County Medical Society, the Florida Medical Society , the Florida Lipid Foundation, National Lipid Association and the American Medical Association.
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