The reimbursement issue causing 'resentment, anger and, frankly, a feeling of injustice'

Matt Mazurek, MD, assistant clinical professor of anesthesiology and director of quality and safety at St. Raphael's Campus of Yale New Haven (Conn.) Hospital, joined Becker's to discuss physicians' biggest reimbursement issues. 

Question: What are your biggest concerns regarding reimbursements right now?

Editor's note: This response was edited lightly for brevity and clarity. 

Dr. Matt Mazurek: Physician service reimbursement has declined year over year for decades, and inflation-adjusted compensation has drastically been reduced. Around 140,000 physicians quit or retired over the past three years and many physicians are looking for a way out of the healthcare system. Part of the problem is consistent downward pressure on reimbursement. Private practices can no longer afford to stay in business. It’s difficult for a physician to take a pay cut in this climate while large insurance companies have somehow leveled a nearly 3 percent increase for Medicare Advantage patients when these companies are making significant profits and executives are earning over seven-figure salaries. 

There is a disconnect in value and the value system. A physician colleague recently told me that no one goes to the emergency room and asks for the administrator on-call or who is in charge of my insurance plan. Administrators do not provide healthcare services. Nurses, physicians, nurse practitioners, physician assistants, lab techs, respiratory therapists and everyone at the bedside at 2 a.m. during a crisis provides care, while the administrators and insurance owners sleep at home.

This  downward drift in reimbursement for physicians with no change in compensation for executives foments resentment, anger and, frankly, a feeling of injustice. Medicine is a science, healing is an art, and healthcare is a business. Physicians are in the business of providing care in an environment that does not value the physician or patient. This is reflected in lower reimbursement for services rendered and higher out-of-pocket expenses for patients. There is a profound feeling of frustration from both patients and physicians.

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