Skip to comments.CASH ONLY, PLEASE
Posted on 07/23/2006 2:42:46 AM PDT by Hostage
Nearly five years ago, my husband and I left a university clinic practice to explore ways to spend more time with our patients. Denied the right to provide services to my patients because the patients' insurer did not deem it necessary, we felt we were losing personal control of the practice of medicine.
Much of my practice was women's care, and the idea of providing comprehensive women's care in 12-minute visits was absurd. Furthermore, to maintain an "efficient" patient flow, my schedule was typically filled weeks in advance with physicals and Pap smears, so that acute care was frequently shunted to one of my colleagues; any possibility of continutity of care was totally lost. Believe me, when a patient is acutely ill, frightened, or in pain, there is nothing "kind" about forcing her to see a total stranger for her care.
We moved to a completely new area and started a retainer-fee practice from scratch. Unlike many retainer practices which cover "extra" sevices while charging insurance and/or Medicare for the usual covered services, our fees cover the entire cost of the medical care.
We are not on contract with Medicare, Medicaid, or any insurance company, although many of our patients still retain traditional insurance coverage for secondary services, hospitalization, medication, etc. However, they pay us out of pocket for the personalized care we provide them.
Ironically, our monthly care fees are considerable lower than the "access fees" that insurance e-based retainer practices charge for the "extra" services.
The bottom line is that we are very affordable.
Two years ago, our state insurance commissioner decided that he did not approve of the concept of "concierge" medicine and announced that he would shut us down. We pointed out that, far from serving only the wealthy, we in fact provide care for many groups of people who could not otherwise afford care of any kind, or might otherwise abuse emergency rooms for outpatient care. Even our maximum monthly charge (which is for housebound adults who require in-home care) is only $100 a month, regardless of utilization.
So, yes -- retainer-based medical care can be kind. But perhaps you can see why we take exception to the term "concierge".
United Healthcare's CEO has a salary well in excess of $200 million per year and is presently under SEC investigation for $1.9 billion (B-I-L-L-I-O-N) in backdated stock options.
Is United Healthcare the group who is providing the care for a fee, or is that the Washington State Health commissioner's group? The newspaper link did not work.
Medicine is now at the point where insurance companies are dictating to doctors how they should practice medicine while demanding huge premiums. They are also constantly bitching to keep costs down at the expense of patient health. I find this all rather disgusting to say the least when CEO's of the HMO's are making millions per year.
Malpractice insurance isn't getting any cheaper either. I agree with you. Charging patients what they can pay works. Not dealing with insurance billings also keeps the overhead down. Working out of your home keeps costs down also.
(Go Israel, Go! Slap 'Em, Down Hezbullies.)
(Go Israel, Go! Slap 'Em, Down Hezbullies.)
United Healthcare is a publicly traded corporation. I added a comment about their CEO to provide a contrast, otherwise the author made no mention of United Healthcare specifically.
But United Healthcare is known to fight doctors at every turn for patient coverage. In other words thay don't pay unless you spend countless hours on the phone badgering them.
United makes money by not paying doctors for service meaning not allowing doctors to provide medical services to patients that have United as their health insurer. Or put it this way, the doctors can provide care for free unless they charge a so-called "concierge" fee.
I have no qualms with CEOs making a gazillion dollars for inventing a better mousetrap. But making money by denying patients their health benefits rubs me the wrong way.
I know a primary care physician who takes fresh fish and other food items if patients can't pay in cash. He can't cook and they bring him food. Pretty good arrangement. It's not extremely lucrative, but this physician isn't in it for the money.
"Just try getting your insurance company to pay for your attorney's services."
Check out a company called Pre-Paid Legal Services (PPD). There apparently is a market for what they do. I don't use their services, and have managed to stay out of court and not really needed it. On the other hand, I've been lucky enough to remain basically healthy and have not really needed the medical services that I have paid for through my health insurance plan, either. Looking back, I would have been better off paying out of pocket for the few times I have needed medical care over the years and saving on the ongoing premiums, the same as with my legal needs. But I didn't know that going forward and it seemed the better course to have the health insurance. However, I can't see the principled difference between that and the legal insurance I passed up. In both cases, I would have been happy to have the coverage if things had gone wrong in various ways that they did not.
I posted similar info a while back about some cash - only health providers that would let you have a REAL doctors visit for like 25 bux out of pocket. You basically had only to pay them cash and sign some statement saying you would not sue them for malpractice.
The post was attacked by somebody who said it couldn't possibly be true, as no hospital would admit someone from a doctor who didn't have up to date malpractice insurance.
Back before insurance companies went whole-hog at the trough and the government got involved in health care, you could actually AFFORD to go have a regular doctors visit, or even have one come to you.
Your link doesn't work and when I went to the website I couldn't find this article. In which issue of the journal was this article published?
There was an OB-GYN who recently passed away on the Island of Maui. He was eighty years old and had practiced on the Islands for well over 50 years.
He often accepted a lettuce or sack of onions or other produce in return for services. Don't ever remember hearing of any trouble with the IRS but he did have trouble with his wife. He would often make house calls while she would wait for him to return to the office. But he would take sometimes hours for a one-hour call and return with a pineapple instead of a check or cash.
He used to spend countless hours talking and catching up on the latest gossip and local politics with his patients while getting a lettuce in return. Drove his wife nuts.
Needless to say he was a favorite doc in Maui. And he did have a grand lifestyle there regardless of how people compensated him.
Sorry to say it is an editorial and is not listed under the website's articles.
I just tried this link and it worked. Don't know why it isn't working otherwise for you.
Your link is misspelled in your post: you spelled it ww.physicianspratice.com. Please ask the mods to fix your spelling.
Thanks for pointing that out. How do I ask the mods?
Just post a reply to Admin Moderator and they should fix it fairly soon.
This is the cure for Medicare and Medicaid too. Instead of CMS rules and regulations, just give poor seniors and those with clear disabilities a $50,000-per-year healthcare account in the form of a debit card. Of course there'll be monthly premiums to keep costs down - but no more deductibles, co-pays, and other BS. Unused monies won't carry over - whatever the existing balance is will be added to the X amount to bring it back to the $50,000 level. They can use the account to buy prescription drugs (NO MORE "DOUGHNUT HOLE" NONSENSE), dental, medical, vision, nursing home care, etc without the BS. Some FReepers will scream that this is socialism but it's not. This immediately reduces 90% of paperwork and saves billions in bureaucratic costs. The program phases itself out on it's own.
Please fix the link to the source. Thie original was misspelled. It should be:
Sounds like he loved what he did. Which is really the true definition of success.
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