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Originally Posted by jyl
How are ER docs paid? I thought they were contractors of the hospitals?
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Not an ER doc, so my explanation may not be entirely complete of the details, but in general an ER doc is a member (whether employee or partner) of a group. The group (of ER docs) then contracts with the hospital to cover the hospital. The ER doc effectively gets paid by the shift. I don't know if there are any performance bonuses and such written into contracts.
To a certain degree, that's good. The ER doc doesn't get paid directly by the patient, which minimizes any bias the doc may have due to the patient's ability to pay (or not). It's the group that bills the patient/insurance and worries about collection. Often when I get called from the ER, the doc claims no knowledge about the patient's insurance status.
I think it's somewhat important to note that except for recent times (last decade or so), in general doctors have NOT been paid by hospitals. Doctors may work in hospitals, sometimes even exclusively (ER, anesthesia, pathology, radiology). But they usually don't get paid by the hospital. Only recently, with the advent of hospitalists and the general shift of employment away from the traditional solo/small group private practice and towards W-2 hospital-employee status has that changed. Patients may not notice much of a change (though to a certain degree they will), but for the doctor side of things this is a huge change in the employment model; from being an independent to being another cog in the machine.