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"It's A Question of Value"
How are physicians paid?
Nine out of 10 New Brunswick physicians are self-employed . They run busy practices and bill for each service they provide. Like any self-employed business person, they are responsible for all overhead costs associated with that practice — rent, medical equipment, secretaries and nurses’ salaries, telephones, supplies, etc. And, like most self-employed business people, they do not receive pensions and must provide for their own retirement. Overhead costs associated with running their practices are typically in the range of 40 to 50 percent .
Who pays doctors?
In most cases, physicians bill NB Medicare. It acts like your private insurance company administering funds set aside for health care expenditures. In certain cases, physicians bill the Workplace Health, Safety and Compensation Commission (WHSCC). Private insurance companies cover some services not eligible for Medicare coverage. Others may have to be billed directly to the patient.
How do doctors decide what to bill?
For the most part, they don’t. Fees billed to NB Medicare are set as a result of negotiations between the New Brunswick Medical Society and government. For example, when you or a member of your family visits the doctor’s office to check on a health care problem and determine treatment, the typical fee billed to NB Medicare is around $20 . The New Brunswick Medical Society’s billing guide helps physicians set fair and reasonable fees for services not covered by Medicare, such as your annual physical.
So how much do doctors’ fees take out of New Brunswick’s health budget?
Fees to physicians account for approximately 17 percent of the province’s total health care budget. That percentage has remained at a relatively constant level for almost 20 years.
Do doctors get paid for every hour they work?
No. Many New Brunswick physicians, for example, work more than 50 hours per week and that doesn’t include nights and weekends on call. They set aside some of those hours to return calls to patients and their families, to other physicians and even to schools and employers. They must update charts and attend professional development courses. There is no one to bill for any of that time.
As well, many physicians contribute hundreds of consultation hours to health-related government and hospital committee work requiring physician input. |
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