Market woes: Physician businesses wonder whose grass is greener

Conditions may not be great anywhere, but there are identifiable factors that contribute to making them better or worse.

By Cheryl Jackson, AMNews staff. Jan. 21, 2002.

Think business is bad where you are? Pennsylvania doctors walked around the 2001 Annual Meeting of the AMA House of Delegates feeling like the Rodney Dangerfields of the medical world, thanks to fee schedules in their state.

"My reimbursement is averaging Medicare minus 40%," said Martin Bergman, MD, a Ridley Park rheumatologist and president of the Delaware County Medical Society. "People from across the country were laughing at us for accepting 60% of Medicare."

Physicians in Massachusetts last year were playing Henny Youngman, releasing a report that depicted the state as not being a good place for doctors. (Take my market ... please!)

But rim shots don't normally accompany such cracks. Speak with most physicians, and they'll indicate that practicing in their home markets is no laughing matter, because, they say, they find themselves the punch lines of what they surmise is a bad joke begot by managed care.

Things are bad in the market -- whatever market Joe Q. Doctor happens to be in.

How is it that doctors in each region believe they're so much worse off than others?

Recruiters say doctors often only think they're in the worst markets. They don't really know any better, said Don Rainwater, co-chair of the education, membership and marketing committees of the Assn. of Staff Physician Recruiters, a group of hospital-, health system- and medical group-employed recruiters.

"They don't have an outside frame of reference," he said. "Whatever bad happens to them is personalized." So while it seems terrible, compared with what physicians in other parts of the country are experiencing, it may not be that bad. [...]