Shifting baseline is a very real phenomenon in my profession as well.

My predecessor used to get paid ~ $3500 for a cataract surgery in his prime. He decided to retire when Medicare cut the fee to ~ $1300. "NOT sustainable" is what he figured, so he sold out to some hungry young buck almost 30 years ago that would do it for the discounted rate.

And now as my career is winding down after 5 presidential administrations that have taken seemingly innocuous "little" bites out of our fees every year, Medicare has continued to erode the value of my services. Even though I deliver a better more elegant faster-healing visually superior cataract operation than 30 years ago, they only pay about ~ $500 for what is often life-changing micro-surgery for the patient.

Some young buck is gonna take over at some point thinking the $500 cataract is "normal"... cuz they haven't ever experienced anything better. If Medicare suddenly decided to throw them a $600 bone to keep their loyalty, they'd be thinking they got a 20% raise, "Hell yeah... sign me up!"

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"Let every angler who loves to fish think what it would mean to him to find the fish were gone." (Zane Grey)

"If you don't kill them, they will spawn." (Carcassman)


The Keen Eye MD
Long Live the Kings!