Wowerenga, yemwe ndi dokotala wamtsogolo , adafunsa mafunso okhudza malipiro a madokotala malinga ndi kukula kwa dera la anthu. Kodi madokotala amapeza zambiri m'matauni ang'onoang'ono kapena mizinda ikuluikulu, ndipo n'chifukwa chiyani?
Pokambirana za kubwezera madokotala, kugwiritsa ntchito mawu akuti "malipiro" kungakhale kusocheretsa, popeza madokotala ambiri sali ogwiritsidwa ntchito, komanso sapatsidwa malipiro ochepa.
Ambiri amachilendo (oposa 50%) ali ndi bizinesi okha, amakhala ndi chizoloŵezi choyera payekha kapena mbali, mosiyana ndi kugwiritsidwa ntchito ndi chipatala kapena gulu. Ngakhale kwa madokotala omwe amagwira ntchito, malipiro awo amayendetsedwa ndi malo ambiri, chuma, ndi chiwerengero cha anthu, monga kusamalidwa bwino ndi kubwezera inshuwalansi, zomwe zimayikidwa ndi mabungwe a chipani chachitatu ndi malamulo a boma.
Malingana ndi Medical Group Management Association (MGMA) yomwe imayambitsa kufufuza kwapadera kwapadera ndi kuyerekezera chipatala chamankhwala, madokotala ambiri amalandira ndalama zambiri m'madera omwe ali ndi anthu oposa 1 miliyoni. Muzinthu zambiri zapamwamba, opeza ndalama zambiri amapezeka m'matawuni a 50,000 mpaka 250,000, malinga ndi ziwerengero za MGMA.
Kusiyanitsa uku kulipira chifukwa cha zifukwa zingapo:
Mpikisano
M'madera aang'ono mpaka pakati, mpikisano ndi madokotala ena siwowoneka ngati m'madera akuluakulu, omwe amakhala "oposa" chifukwa cha madokotala kuti azipita ku mizinda ikuluikulu chifukwa cha chiyanjano cha banja kapena phindu la kugwira ntchito mumzinda wawukulu.
Kubwezeredwa
Kubwezeredwa kwa makampani a inshuwalansi kumawoneka kuti ndi apamwamba kwambiri m'midzi yochepa. Choncho, dokotala wina mumzinda waukulu ndi dokotala m'tawuni yaing'ono amatha kuona momwemo komanso mtundu wa odwala, ndipo amachitanso ntchito yofanana, ndipo dokotala aliyense akhoza kubwezera ndalama zosiyana mosiyana ndi chiwerengero chawo , ndipo kawirikawiri ndi doc yaing'ono yomwe ikupita patsogolo.
Ndalama Zam'tsogolo
Kawirikawiri, ndalama zogwiritsira ntchito ngati dokotala, monga inshuwalansi yochuluka, ndi malo ogwira ntchito, ndi apamwamba m'mizinda ikuluikulu. Izi ndichifukwa chakuti mizinda ikuluikulu imakhala malo ovuta kwambiri kusiyana ndi madera ang'onoang'ono, ndipo milandu yowonongeka imayendetsa mtengo wa inshuwalansi yachinyengo.
Zitsanzo
Odwala Opaleshoni Ochita opaleshoniwa amapindula kwambiri m'matawuni a 50,000 kapena osachepera, makamaka. Mwachitsanzo, molingana ndi MGMA Physician Compensation ndi Production Report ya 2009, opaleshoni ya mafupa m'midzi yaying'ono kwambiri amapeza ndalama zokwana $ 502,195 pachaka ndi $ 474,359 chaka chilichonse m'madera ozungulira akuluakulu oposa 1 miliyoni. Ndalama zawo zapakati zimachepetsanso m'matawuni okhala ndi anthu 250,000-1,000,000, pafupifupi $ 393,402.
Gastroenterologists m'matauni ang'onoang'ono (pansi pa 50,000) amapeza ndalama zokwana madola 467,927. Madokotala awo m'matawuni a 50,000 mpaka 250,000 amapeza madola 452,195 pafupipafupi, omwe amapitirira 22% kuposa omwe amakhala nawo m'madera akuluakulu (anthu oposa 1 miliyoni), omwe amapeza madola 370,673 pachaka.
Dermatologists amapindula kwambiri m'matawuni a 50,000-250,000 omwe amapeza ndalama zokwana madola 395,159. M'madera akuluakulu, akatswiri a dermatologists amapeza ndalama zokwana madola 50,000 peresenti kuposa izi, ndi ndalama zokwana $ 340,317 pamadoko okhala ndi anthu oposa 1 miliyoni.
M'midzi yomwe ili pansi pa 50,000 mu kukula, maluwa amapeza $ 356,624, malinga ndi MGMA 2009 Physician Compensation and Production Survey.
Akatswiri a zamoyo m'matawuni aang'ono mpaka pakati pa mapiri amapindula paliponse kuyambira 17% mpaka 25% kuposa omwe ali m'madera akuluakulu. Zowonjezera zomwe zimapindula zingagwirizane ndi kusiyana kwa pafupifupi madola 150,000 pachaka kwa akatswiri ena a cardiologist m'madera ang'onoang'ono! Akatswiri owona za matenda a m'maganizo akuwona zotsatira zovuta kwambiri za kukula kwa tawuni pa ndalama, mwachitsanzo, ndi ndalama zokwana madola 609,041 m'matauni ang'onoang'ono (pansi pa anthu 50,000), ndi $ 462,820 m'madera akuluakulu (anthu oposa 1 miliyoni).
Pamwamba pali zitsanzo zochepa chabe.
Mndandanda ukupitirira, koma awa ndi zitsanzo zochepa kwambiri. Sizinthu zonse zapadera zomwe zimawona kusiyana kwakukulu kotere, koma pafupifupi zopadera zonse zimapeza phindu m'mabata ang'onoang'ono, makamaka omwe ali opindulitsa kwambiri a 50,000 mpaka 250,000 mu chiwerengero, omwe ali malo opindulitsa kwambiri pazipadera zambiri. Monga bonasi yowonjezera, kuphatikizapo kupeza ndalama zambiri chaka chilichonse, madokotala m'madera ang'onoang'ono amapeza ndalama zambiri, kupeza ndalama zowonjezera komanso madera abwino a zachipatala kwa madokotala omwe amakhala m'midzi yaing'ono kapena ya pakati.