- Del Meyer, MD - http://delmeyer.net -

Forty-five Years Ago (November 1952)

The November 1952 issue of Sacramento Medicine illustrates that practice issues, just as today, were of major concern. The lead article was written at the request of the editorial board concerning the handling of professional collections. John Collins, manager of a credit bureau, discusses the controversy around the recovery of professional accounts. It has long been recognized that professional accounts are a problem in view of the fact that they are not, in most cases, voluntarily incurred as are purchases made in a commercial establishments. This is compounded by the fact that no ailing person is ever knowingly refused service by a doctor. This combination requires the study of each debt as a separate problem to be handled by people trained in the proper attitude and cognizant of the importance of maintaining the high regard of the patient for the profession as a whole. In the field of collection there are two distinct attitudes. There is the co-operative or merchant controlled agency guided by a board of directors in the credit granting and collection work with a professional man on the board who is actively engaged in its work. And there is the independent collector who rightly has the purpose of earning as much money on his investment as is possible. Hence, every account he accepts presents a challenge to be handled in the least possible time, recovered as rapidly as possible, while obtaining as high a commission earned as the contract will permit. This commission is quite standard from 50% on small accounts dropping to 25% on large accounts. Professional accounts are generally mixed in with commercial collections. In either case, it is important for the medical office to work closely with the agency. The author from RCA felt that credit bureau accounts do better since they have the force of being the credit grantor for future needs of the patient.

California Medical Association reported a surplus for the fiscal year and anticipated a surplus for the following year. Some members of the association feel that both a balanced budget and a reduction of state dues would be possible if some unessential expenditures were reduced or eliminated.

The women’s auxiliary has been so successful in their nursing scholarships program that 18 county medical auxiliaries have joined the program. The auxiliary has given a total of 87 scholarships including 24 this year to girls from all ten of the Sacramento County high schools.

The California Chiropractic Association has engaged a professional signature-gathering firm to secure the filing of approximately 150,000 valid voter’s signatures to present an initiative measure to the California legislature authorizing the issuance of “Chiropractic Physician” certificate. This would authorize the holder to do practically everything done by a physician and surgeon except “major surgery, practice dentistry, and optometry.”

The average hospital bed accommodates forty patients a year up from twenty patients a year 20 years ago. During this time physicians incomes increased 41%, hospital rates increased 135%, and production workers earnings increased 165%. During this time the physician’s share of the medical dollar decreased from 32 cents to 28 cents whereas the hospital portion increased 66% from 14 cents to 23 cents. Despite these increases, the American public is spending three times as much for alcohol, recreation, and tobacco as for medical care.

Thirty years ago (Nov 1967)

A San Francisco newspaper report claimed that 1200 California physicians received $70,000 each from Medi-Cal. This precipitated a personal visit by Mr Carel Mulder, director of the Office of Health Care Services, to appear before the CMA Council on November 4, 1967, for a full explanation and apologies. It seems that some reporter had taken the total MediCal gross payment and divided it by the number of physicians receiving payment to come up with $70,000. Mr Mulder pointed out that this included a very large sum paid to the Social Security Administration as premiums in accordance with the buy-in provision of Title 18-B. Also large groups including Permanente were treated as one provider. Doctor Dwight Wilbur pointed out that this seems to be the sign of the times.