re: I hate our healthcare system and PAs/NPs

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They just seem more up to date on treatment than most docs.

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LoL. You're an idiot if you believe this.

If he had to pay $150, it was probably his copay for a "specialist" office visit that is established in his insurance plan.

If he means that the doctors office billed the insurance company $150 for his visit, that's 100% normal. Doctors can charge $150 for a certain level office visit, but they're only paid maybe 40-50% of that $150, including the patients copay, when it's all said and done.

I've been a dermatology mid level provider for almost nine years and I actually agree with you that you should definitely be told if you are going to be seeing the MD or the mid level, everytime, no exceptions. We are there to keep clinic moving and get more people seen. My supervising physicians do the cosmetics and the big surgeries. We see most of the medical patients but will refer to the doctors for the zebras. I have seen thousands and thousands of patients and have had very few complaints over the years. I'm sorry you had a bad experience but we do serve a good purpose especially in dermatology. I can't tell you how many melanomas and other skin cancers I have caught in my time for patients that otherwise would not have been seen. Just food for thought. If you specifically request to be seen by the MD and they won't let you, you should find a new derm clinic.

Let's come off our high horse doc. You went to 3.5 years of graduate school. Midlevels do 2.5. Then you did some on the job training.

While I'm not saying that a mid levels training is equivalent, let's not pretend it's night and day.

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$150 for an office visit to a specialist isn't unreasonable at all. Your gross charges were probably greater than $300. Insurance contract probably got your bill down to $150.

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That's insane for 7 minutes of anyone's time.

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If he had to pay $150, it was probably his copay for a "specialist" office visit that is established in his insurance plan.

If he means that the doctors office billed the insurance company $150 for his visit, that's 100% normal. Doctors can charge $150 for a certain level office visit, but they're only paid maybe 40-50% of that $150, including the patients copay, when it's all said and done.

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1. There isn't one insurance plan I have ever seen where the copay was $150. Sometimes they will make you pay 20%, or 50% or even 100% of the charges, but if it is a copay plan, none of them are $150, yet.

2. For a new patient acne visit with a full body skin exam, the absolute highest code you could charge for is a 99203 which also isn't billed at $150.

3. As far as the meds go, the providers prescribing the medications do not set the prices for the medications: pharmacies and drug companies handle that. Furthermore, different insurance plans cover different medications and it is impossible to know which medicines are going to be covered under each and every insurance plan. If you can't afford the trade products, sometimes there are generics(the cheaper version) and even those can be expensive(again blame the pharmacy because they set the prices)

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It doesn't all goto your doc. You have to pay your staff with that 150. Also cover rent, utilities, liability insurance, advertising, taxes, ect

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Assume the $150 is for a nominal 10 minute visit. (The OP said his lasted 7 minutes.) It's still nuts. Other businesses with similar overhead don't charge anywhere near that $900 hourly rate. And the OP didn't even see a doctor.

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$150 for an office visit to a specialist isn't unreasonable at all. Your gross charges were probably greater than $300. Insurance contract probably got your bill down to $150.

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My annual checkup with my dermatologist had my standard $100 specialist co-pay. He billed my insurance for a standard 15 min offfice visit. Which was correct.

My insurance allowed the charge at $58. I called the billing manager at the dermatologist office and had them send me my $42 back.

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Everything is done indirectly. 

I'm sure the pharma reps are there at least a couple times a week treating the office to lunch and whatever else.

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The days of kickbacks are dead and not coming back. Your Doc isnt making anything by prescribing anything. Also staff lunches arent much of a benefit. (Most staffs would rather have a quiet lunch then listen to a rep)

We cant give anything of value anymore and it all gets tracked.

Part of the ACA was the sunshine act which tracks anything of value that is given to a doc and puts it in a database. There are major fines if its not adhered to.

Go to this website and search if you want to see which reps are doing lunches etc for your doc.

open payments

You must have missed the day in college when you got to decide what you wanted to be when you grow up.