Doctors Going Broke
Doctors going Broke
A CNN story two days ago reported on physicians in our country who are bankrupt from giving care and the numbers of doctors being forced out of practice by their inability to make a living. It sounds crazy, right? Is this a joke? How could this be when doctors drive nice cars and live in expensive houses? It’s true and it’s frightening. We are in danger of losing independent private medical practice. And, America, you aren’t going to be happy with the alternative: corporate medicine where care is dictated by the bottom line; a system where compassion and the intimate relationship you want with your physician is unavailable.
Last year, my income was down 20%. I’m a smart guy so I took the time to look at the reasons.
1.I practice medical Dermatology in an area with a high percentage of blue and lower white collar workers . The recession hit hard. Last year, copays and deductibles rose causing patients to avoid physicians. At first, I thought it was because, as a Dermatologist, my services are somewhat of a luxury (except the day before the prom when every teen wants their acne cleared overnight). But I got calls from dentists, urologists, cardiologists and other “necessary” specialists who said that their offices were much emptier than usual.
2. Doctors, myself included, aren’t the best businessmen. Maybe it’s because we have hearts. None of my patients would ever think of checking into a hotel or renting a car without giving a credit card to settle the bill. None of them go to the beauty shop without payment for services the same day. But because insurance companies pay most of the bills and that takes time, patients are a step removed from settling their accounts and they pay the doctor last (sometimes not at all) because, don’t you know — we’re all rich and don’t need the money. Or, patients are unhappy with what the insurance company says is their part and refuse to pay while they argue with the company. They forget doctors don’t have the same option with our landlords or our staffs who insist on receiving their salaries on time. I have thousands of dollars in receivables from patients who pay for their cable television on time, have money for cigarettes, and take vacations but tell me that they will pay me when they ''check things out with their insurance company''.
3. It costs me more to provide excellent care. This year, I have to buy an electronic medical record system for my office. Although the government and the owners of the software companies tell the public it will improve care, I don’t see how. All is really does is cost me more, take time away from personal interactions with patients, and generate piles of useless data for insurance companies. And the kicker is that with increasing costs, insurance companies work hard to pay doctors less each year. But because we doctors continue to provide care no matter how low Medicare reimbursements go, the public does not complain to Congress. They only raise their voices when a cut in cost affects them.
What’s the solution?
1. Doctors are discussing taking credit cards and charging patients’ accounts after insurance companies determine the patient portion of the benefit.
2. Boutique medicine might become more popular. You might have to pay for the privilege of seeing a certain physician. Hopefully, the level of service you receive would be worth the extra cost.
3. Maybe we should get honest and get our priorities straight. Pay your medical bills. That sounds simple.
More than anything, the solution is to stop burying our heads in the sand and realize we have a huge problem. The healthcare reform bill passed by Congress has NOTHING to do with healthcare reform. It’s a bonus for insurance companies. The very name of the bill is a lie. We’ll only solve this problem if doctors and patients dialogue and work together with mutual respect. We need to provide you with excellent care. You need to pay for the medical services you receive without excuses or fabrications. As much as I am open to giving free care to patients who truly deserve it, I am not an interest-free loan company for the rest of you. Let’s start to talk about the problem, America and instead of finger pointing, let’s discuss solutions. We all will lose if we continue on the current course.
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