When you consider that the PE firm that owns her group skimmed half of that off the top, if she met with you for 1.5 hours, she spent at least twice that time thinking about you, ordering meds, completing notes, and answering questions from the rest of the team caring for you, she probably made about $250 an hour or less.
Then consider that she accepted liability for you. Which includes the possibility that if you had a bad outcome your family could sue her for more than the total payout of her malpractice insurance, so she could literally lose her house.
And palliative care requires a fellowship so she has 12 years of total training with probably $200k-$400 in student loans. And she didn’t start making any serious money until her 30s. Then factor in that she’s on call constantly and frequently works terrible hours and she pays thousands a year in certification fees, and continuous education (plus in most cases hundreds of unpaid hours a year training residents and med student, sitting on advisory boards, or other unpaid expected service work).
The entirety of what she did was record keeping. Palliative care is a broad term, but she did not (a) do any diagnosis, (b) prescribe or change any meds, or (c) treat me in any way. She was basically an extension of the case manager. Our most impactful meeting was when she recorded the names, phone numbers, and associations of my emergency contacts, which had already been done a few days prior. Had she never shown up at all, nothing about my stay or outcome would have changed.
I didn't pay $250 an hour. I paid a thousand an hour. You don't get to arbitrarily eliminate money because it didn't go directly to her. It still got paid.
Just because she didn’t directly prescribe you medications or perform any procedures doesn’t mean she didn’t make recommendations to the intensivists who were managing your care.
If she really didn’t change anything about your treatment (as opposed to you just not knowing what was changed), the most likely explanation is that the ICU ordered a consult, and after talking with you and your doctor, and going over your notes, she came to conclusion “nope there’s nothing to change here. good job everyone!”
Would you have preferred that she’d made a few unnecessary changes to justify the bill?
Palliative care requires fellowship training, the doctors burn out quickly, and there’s a shortage of them. There’s no reason for a hospital to waste them on record taking.
>a thousand an hour
You didn’t pay $1k an hour. You paid $1500 for services that included 1.5 hours of direct interaction. I guarantee if she talked to you for 1.5 hours, she spent much more time than that.
As for eliminating money that didn’t go to her. You said “she charged you”. She didn’t charge you. Her group did. She was called in, did her job, documented what she did, and her group figured out what to bill you for based mostly on what insurance companies are willing to pay.
If you think you were charged too much, you can blame the PE firm that owns her group.
When you consider that the PE firm that owns her group skimmed half of that off the top, if she met with you for 1.5 hours, she spent at least twice that time thinking about you, ordering meds, completing notes, and answering questions from the rest of the team caring for you, she probably made about $250 an hour or less.
Then consider that she accepted liability for you. Which includes the possibility that if you had a bad outcome your family could sue her for more than the total payout of her malpractice insurance, so she could literally lose her house.
And palliative care requires a fellowship so she has 12 years of total training with probably $200k-$400 in student loans. And she didn’t start making any serious money until her 30s. Then factor in that she’s on call constantly and frequently works terrible hours and she pays thousands a year in certification fees, and continuous education (plus in most cases hundreds of unpaid hours a year training residents and med student, sitting on advisory boards, or other unpaid expected service work).
I think $250 an hour is pretty fair.