I explicitly laughed at one sentence of OP, which you decided not to quote!

For the rest I gave him an explanation of the Swiss system.

Okay.

The Praxis already does that by default. Funny story about that, they only send the total amount to my insurance, so my insurance has no idea what I am charged for either. I had to ask the Praxis to send me copies of detailed invoice.


Thanks for your link! I actually consulted and re-visited that link many time during my navigation of Swiss psychotherapy system. Your information was definitely helpful, so keep up the good work

Would you mind sharing the costs?
I'm trying to grasp the system as well

- Consultation, first 5 min: 16.56
- Consultation, every following 5 min: 16.56
- Consultation, last 5 min: 8.29
- Zuschlag für hausärztliche Leistungen in der Arztpraxis: 9.68
- Aktenstudium in Abwesenheit des Patienten bei Personen: 16.56 for 5 min
- Nicht formalisierter Bericht: 36.43

somehow the lavish salaries have to be paid:


https://www.praktischarzt.ch/arzt/gehalt-arzt/

Thanks!

Labour costs for administrative work:

Do you mean the Aktenstudium in Abwesenheit des Patienten? After examining a patient, studying the files in the absence of the patient can be one of the most important tasks a doctor can do. It is not office administration, but reading up on the lastest medical research relevant to the patient's needs, and perusing the medical record and test results, to determining whether a particular treatment could be beneficial or contraindicated, etc.

The income of doctors is on the political agenda and therefore one always has to look at the source. From 2014 onwards, the FMH was forbidden to publish their own numbers. The state has an interest in decreasing costs, i.e. in overestimating doctors‘ remuneration, and tbh the numbers in your source strike me as far removed from reality. Here‘s the FMH, as far as they are allowed to speak for themselves:

https://www.fmh.ch/themen/aerztestat...haeltnisse.cfm

https://www.fmh.ch/files/pdf21/saez_07264_de.pdf (a breakdown by pay per hour - full-time in medicine means 55 h per week, a definition I would prefer to change but that is endorsed by the FMH itself)

Tarmed was explicitly designed as a time-based tariff, resulting in an hourly fee of about 200 CHF, which covers the rent and the salary of employees, as well as the amortisation of a six-digit infrastructure. (For shrinks, the six digits go into therapy/supervision). I find working against a clock as demeaning to myself as to the patient and often don’t do it, e.g. taking detailed histories or explaining tricky situations for a total of more than the 18 minutes of conversation I’m allowed to bill as a non-shrink. Of course that’s a luxury not all of us can afford. One very thorough and decent colleague called her own practice an expensive hobby in the years when her children were small. It‘s not a business model well suited to part-time work, so many new parents prefer employment in a group practice.

Thanks to doropfiz for pointing out the importance of the Arztleistung in Abwesenheit. Coordinating treatments with different specialists is a large part of what good GPs do, especially for old or chronically ill patients, and it is absolutely vital, not only to patients: it is way cheaper to avoid doing the same MRI twice, but someone has to actually notice it‘s been done before. Same goes for doctor-shopping, which has become so popular that I refuse to give out appointments for second opinions until after I‘ve reviewed the records. Otherwise everything ends up getting done twice (or three, four or five times). It all sounds very simple to the young and healthy. But for most of us, the time will come when we understand, even if it takes a few decades :-)

doro, slight disagreement on one point only: it would never have occurred to me to bill research on Medline and the like. That comes with the job and is part of permanent education, and actually an interesting break of routine. I believe Aktenstudium in Abwesenheit is strictly for the file of the patient concerned, e.g. other doctors‘ reports.