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Ask most Americans how much it costs to visit their podiatrist and they probably do not know. Ask many podiatrists what their fees are and they're not likely to know them all either. Health care prices, physician fees, and prices of medical procedures and treatments have been cloaked in mystery for decades. But as the number of people who are uninsured, underinsured or are opting for higher-deductible insurance plans grows, podiatrists have reason to care now more than ever.

In the past, most physicians did not worry about payment for a visit because patients had health insurance through their employers. But with the economic downturn things have changed. There are approximately 72 million uninsured and underinsured and many others whose coverage include high premiums and deductibles. Patients have also been encouraged to join consumerdriven health care plans and tax-free savings vehicles such as health savings accounts (HSAs) or health reimbursement arrangements (HRAs), in which up to $2,000 comes out of their pocket.

Unfortunately, several barriers exist to price transparency. First and foremost, there is no standardized price list for doctors' fees or medical procedures. Moreover, there are many payment systems, both public and private, making it difficult to both understand and dissect. Prices on products and procedures vary widely. Adding to the challenge are the insurance companies who often hide their pricing structures so rivals do not have access to rates negotiated with physicians. This creates confusion when doctors try to address patient concerns regarding the price of procedures and treatment. Fees and costs also vary significantly across geographical regions. So the question remains, just how much money actually goes into a podiatrist's pocket?

This is an approximate breakdown of a $100 new-patient appointment:

$9 for malpractice insurance

$4 for equipment and maintenance

$8 for supplies

$6 for rent and utilities

$10 for office expenses such as telephones, accounting

fees, advertising, medical journals, licenses, and taxes

$28 for staff salaries and benefits

$35 for the doctor

The annual salary of the average podiatrist is only about $114,000 a year. With reimbursements from Medicare and private insurance diminishing, paired with income tax and self-employment taxes, net income is at all-time lows. These calculations also exclude the 50% or more of podiatrists that have student loans for tens or even hundreds of thousands of dollars. If pressure on provider salaries continues there will eventually be no providers left to pressure.

 

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