Interesting article and comments:
http://psychiatrist-blog.blogspot.com/2008/05/i-have-good-doctor.html
If a doctor's office does not "take insurance" it does not mean their services are not covered. They're just not going to file the paperwork on your behalf or float you a loan while they wait to be paid by the insurance company. HMO's typically don't reimburse for out-of-network doctors (unless it's an emergency) but other plans often do.
[QUOTE=JasmineRain]If a doctor's office does not "take insurance" it does not mean their services are not covered. They're just not going to file the paperwork on your behalf or float you a loan while they wait to be paid by the insurance company. HMO's typically don't reimburse for out-of-network doctors (unless it's an emergency) but other plans often do.
[/QUOTE]
All true, of course. This article was about the perception that a doctor who could say, 'screw it, I'm not filing your paperwork, or floating you a loan' and still have a thriving practice 'must' be a good doctor.
I totally disagree.. I live near several teaching universities w/ medical training.. and my RD is a professor at UofPenn. I strongly disagree based on my own experience regarding my GYN, my Endo, my GP, and the Ortho's I've seen. Only the original RD that I saw who told me I HAD A VIRUS!! is not worthy of payment in any form. I pay /visit and I rarely wait any more than 20 minutes... I've had major attentions to my medical needs this past year and we've reached some improvements which are still increasing..
I truly could care less about bedside manner. I don't want to be his/her friend.. I agree with Babs. Great doctors take insurance.
Jan
It seems like people are missing the point of the article. If you read it, it isn't saying that doctors who take insurance are bad!
It is saying there is a
perception that if you can say 'I don't take insurance' and get away with it, you must be somehow more elite.
This is a strange article. According to the writer a good doctor should be able to fill his/her practice w/private pay patients. In my opinion, a "good" doctor is someone who does charity care, takes on the Medicare and Medicaid patient that many other doctors refuse to treat, despite low reimbursement rates, w/all the headaches of the paperwork they may bring.
From the article: "Insurance companies now are starting to institute "pay for performance" indicators of quality: timeliness of appointments, adherence to practice guidelines, treatment outcome measures and patient satisfactions surveys." So now "for profit" insurance companies are going to dictate who I should see? I guess that would leave out my RA doc who I've seen for 21 years and continue to see despite often having to wait an hour or even two to see him. He spends too much time w/his patients. Does that make him a bad doctor? To me someone who visits you in the hospital at 6am on Easter morning and several times at a nursing home at 5:30 am on his way into work which starts at 7 am is a damn good doctor.
Joie, what you state are reasons they cite as being given by patients as their criteria for a 'good doctor'. Then it gives examples of what professional physician associations would consider criteria for a good doctor, then what insurance cos. look for. Not much overlap, is there?
Sorry Suzanne, I scanned article, and in this 100 degree weather, my comprehension is getting muddled.
[QUOTE=Joie]
I think bedside manner is important. A doctor who cares can make a big difference. A lot of that is by digging for answers and answering questions, and also being your advocate when dealing with insurance and medications. They genuinely care.
The few doctors we've dealt with who don't deal with insurance do charity work, volunteer at the free clinics in the area and/or put in hours at the health department clinic (very low pay), donate $$$ to local causes, etc.
[QUOTE=JasmineRain]The few doctors we've dealt with who don't deal with insurance do charity work, volunteer at the free clinics in the area and/or put in hours at the health department clinic (very low pay), donate $$$ to local causes, etc.
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So true! Just because they do not want the insurance hassle, and can have a successful practice without it, doesn't mean they aren't good-hearted.
The more I read these dr. blogs, they are just as frustrated with insurance as patients are; they want to be paid for their services like a plumber would be, without all the hassle, and they know they will have patients who can't pay sometimes, and they will deal with that.
LANGUAGE WARNING, but here is an example of frustration:
http://docsontheweb.blogspot.com/2008/05/consults-circa-emtala.html
[QUOTE=Suzanne] [QUOTE=Joie]
I guess that would leave out my RA doc who I've seen for 21 years and continue to see despite often having to wait an hour or even two to see him. He spends too much time w/his patients. Does that make him a bad doctor? To me someone who visits you in the hospital at 6am on Easter morning and several times at a nursing home at 5:30 am on his way into work which starts at 7 am is a damn good doctor.
[/QUOTE]
Maybe the doctors you describe are the ones who are going to be forced to stop taking insurance or change the way they practice? What you describe sort of proves the point of the article. Good doctors who are fed up with insurance cos. 'pay for performance', etc. They get to continue being good doctors and their patients file their own claims.
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Hmmm, I think some doctors fed up with insurance companies, the administrative headache of our health care system, may simply quit, retire early, work for an HMO or the insurance industry as a reviewer. My RA doc sees a lot of older patients, like my Mom, and I don't see old-timers like my Mom submitting claims and monitoring it all, most folks on Medicare have two policies, so file two claims, nope my Mom would have been confuuused. I don't have problems w/any of my doctors, I'm disturbed by the for profit insurance companies that seek a profit at the cost of denying coverage to those w/preexisting conditions and practices like finding an excuse to drop a sick insuree when they submit costly claims. If docs are fed up with insurance companies, and patients dissatisfied, then perhaps we need to regulate the insurance industry or simply exclude them and consider a more efficient, simpler, single payer system -- patients could still choose who to see, and docs and hospitals would be private, $$ would be saved, and gazillions of paperwork from the multitude of private insurance plans would be eliminated. Just a thought on this very hot day -- its breaktime for some ice tea. Joie, excellent posts and information.Joy -
I've seen a lot on this 'pay for performance' issue - but apparently didn't think to keep it. Sheesh. There was an article in either the LA or NY Times on the problems with it. And I think it was over a lawsuit filed that it got reported. Basically, it's not for 'preventative' measures but mostly on patient satisfaction. I think the lawsuit was because in order to cut costs people weren't getting referrals. The ins.co's are looking at bottom line.
Ah - whats EMTALA?
Pip
[QUOTE=Suzanne]
The more I read these dr. blogs, they are just as frustrated with insurance as patients are; they want to be paid for their services like a plumber would be, without all the hassle, and they know they will have patients who can't pay sometimes, and they will deal with that. [/QUOTE]
That's how it's done in Canada, although the plumber makes more (jky). They better stop that crazy talk or you might end up with single payer insurance.EMTALA - The Emergency Medical Treatment and Active Labor Act
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