Are Doctors Hooked on Insurance?
Doctors don’t like insurance companies. They generally accuse insurance companies of eroding their autonomy, unnecessarily increasing red tape and continually assaulting their incomes. The question must be asked, however, how did doctors ever get themselves in this position and more importantly, how do they get themselves out of it? It’s not difficult to understand how doctors got trapped into their predicament. It IS difficult, however, to understand why doctors continue to enslave themselves to their insurance company masters.
Then, in the early 1980’s, some Ivy League professors proclaimed that America was heading toward a healthcare cost crisis; that increasing healthcare costs would soon exceed all of the profits of corporate America. In order to control costs, a new creation called managed care was born. Doctors reacted with shock! Could it be true that doctors were not really in charge? Could it be true that they had been seduced into a relationship that later would prove to be destructive? Doctors tried to fight back by forming IPA’s and networks. Some even tried to start their own insurance companies.
What doctors failed to see at that time was that they were in the early stages of a destructive addiction. They had become hooked on the drug called insurance. It made them feel good and powerful but it was only temporary. As all drugs do, it blinded doctors to the reality of what was happening to them and how to get out. Like an addict, most doctors came to believe that there was no other way to survive without their drug. Even worse, doctors became willing enablers to hook their patients on the same drug. Patients, too, came to believe that they could not survive without dollar one insurance coverage. To continue the addiction metaphor, doctors and patients became co-dependent enablers to each other, both hooked to the drug called insurance.
Could it be that there is a way to detox doctors and patients and restore health to the relationship; to create a healthy relationship between doctor and patient without the interference of a third party? The answer again is YES and like any detox process, it starts with opening the eyes of doctors to a new reality. Start by asking some fundamental questions. How have doctors come to believe that the only way to make a living is to be paid by insurance companies? Why were doctors willing to give up their autonomy so easily? Why do doctors think that patients are unwilling to pay them as they do their lawyer and accountant? Why have chiropractors and Naturopaths avoided the insurance addiction but MD’s have not? How can doctors capture part of the billions of out of pocket healthcare dollars spent by American consumers? Why will consumers spend $500 at a lawyer, $200 at an accountant but balk at a $30 co-pay at the doctor’s office? These are questions that every doctor must ask on their path of recovery. There is freedom from addiction on the other side, but every doctor must first re-think one of the most fundamental components of their professional lives, that is, How do I get paid?
As a podiatrist who began practicing in 1988 (the tail end of the “Golden Eighties,”) I think this article is extremely accurate of what has happened to physicians. I don’t think newer practitioners even know “what was then” vs. “what is now” as they never experienced the changes in how we’ve been paid over the last three decades. What a great history lesson and, I hope, the impetus for a payment revolution!
Lisa M. DeTournay, DPM
Sorry bad analogy. The reason that people “balk at paying $30 to there doctor” is because if they don’t have the $30 it could lead to death. No one ever died from not paying an accountant. People die from flu complications and other issues because they can’t afford the copay.
Interesting article. Definitely makes you stop and take notice. I forwarded this on to not only our physicians in the practice but to billing as well.
This article is incorrect. The majority of naturopaths and chiropractors are also hooked on insurance just like MD’s and DO’s. Patients have become dependent on it and accepting it is mandatory in many patient populations. Reimbursements are beyond pathetic for ND’s and DC’s and it’s getting worse. Many patients will not see a doctor unless insurance is accepted. Of those willing to pay the doctor many are not willing to pay reasonable fees and seek deep discounts for their care. Sure there are some successful ND’s and DC’s but for each successful one there are 9 struggling. The return to patient payment and responsibility cannot occur fast enough for me. If we are going to have insurance then there needs to be true parity and fairness in reimbursement. From my point of view, dentistry is the profession that seems to have the fee and reimbursement issues well under control.
Funny story I was talking to a friend of mine the other day in his early 60′s he was REALLY sick. When I inquired about him going to the doctor he told me his insurance wan’t effective for another 20 days. SO?! He had this entire thought process as many in that generation have been ingrained with that I CANNOT go to the doctor if I don’t have insurance. It was interesting that he NEVER even considered going in. I explained that he could pay cash and he did go and ended up paying only $72 for the exam, and labwork and they gave him sample drugs. He was ECSTATIC at this new found freedom. I love being able to educate people I wish we could do it on the masses!
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