Cross-posted in GD. My doctor (GP) is stopping acceptance of all health insurance

[madinmaryland]

and is going to a flat fee of $2,000 per person per year. First I had ever heard of this. I can understand hating insurance companies, but it seems a little drastic. This is what I going to send to the doctor. I left the doctor's name in for DU to see.

-----

To whom it may concern,

Our family received your letter this afternoon indicating you would no longer be participating in any medical/health insurance company whatsoever. It left us a bit confused. I would like to address a few issues.

First of all, there are two of us who would qualify for this plan, which would be classified as "well insured" by your plan. We have the option of medical insurance either through my wife's employer (Howard county government) and myself through my employer. As I am sure you are well aware of the cost of insurance to us and our employer is well over $15,000 per year. I would like to ask what the additional $4,000 would add to the value of our coverage.

Now, per your documentation, your plan covers my wife and I for the following. These are all items our insurance company currently covers (and will cover next year) for us, with our only expense being a $20 co-pay.

• All office visits
• An annual physical examination
• Lab work only related to and required by the annual physical examination.

Let us now take a look at the some of the examples you have included in your letter as to why our expenditure of $4,000 would be beneficial to us.

• When you call the doctor you get put on hold or you have to push a number of buttons in an automated answering system to get to the voice mail system for my doctor. This is an inconvenience, but over the last four years Dr. Reisett has responded within the day, or someone from the office has called us back.
• When you are finally offered an appointment it may not be soon enough or you may not be able to convey to the assistant what the problem is. The doctors and assistants have always been able to fit us in for any of our needs. If a patient is calling with an emergency, they will generally have a good reason for calling (i.e., they really are sick and want to see someone)
• They may wait an hour or more in the waiting room or feel rushed throughout the appointment with the doctor. Again, we have never experienced anything this drastic, though we understand that issues arise that are out of control of the doctor and the office and can cause an extended wait in the office.
• Simple answers are not answered over the phone and they cannot be answered by email. When I first met Dr. Reisett, I asked about email and was told the policy of the office was no email. I understood it to be a liability issue (i.e. a doctor making diagnosis' without actually seeing the patient.) If on the other hand, the issue is that the doctors would be spending extra time answering email queries, then as an alternative of some amount per year to patients who want email access to the doctor. As an example, for myself, I could relay my BP reading to the doctor so that he would be able to notice any abnormalities.

To make a comparison, will this work? What if other practices went to this type of payment schedule? We do have needs for other physicians including the following, hence the need for us to carry health insurance, which again begs the question, where is the additional value being added that we are not already getting from your practice.

• Pediatrician
• OB/Gyn
• Endocrinologist
• Neurologist
• Urologist
• Chiroprator (insurance companies do cover these folks)
• ENT
• Podiatrist
• Emergency/Hospital medical care

We have not seen any real justification in your letter as to why you feel the necessity to move to this plan. The underlying reason that I can gather is your refusal to deal with insurance companies and medicare providers. I think we can all agree that the existing "for profit" is extremely wasteful, redundant, and the worst possible system this country can have. This can only be solved by moving to a single-payer or universal health care system and taking the PROFIT out of the insurance part of health care.

I would like to say that I am sorry that you have been overburdened by the insurance companies requirements and by the volume of patients. Additionally, I would like to ask you and Dr. Reisett if you really believe that the items listed above are worth $4,000 per year. We feel a bit insulted that you try and rationalize us paying you $4,000 a year, so that you can provide us with better customer service. I am left with the feeling that you are frustrated with the health insurance companies (we all are - and go back to my comments above) and you willing to torpedo your practice or you really want to just be a service provider to the wealthy and elitist clients from the right side of the aisle.

-----

Does anyone have experience with something like this?

[TZ]

1. Talk to Lizerdbits

She has gone to/ goes to a doctor who does NOT accept any insurance. She's the only example I can think of. Maybe you should PM her.
I wonder what happens to the chronically ill patients who end up with more than 2,000 worth of expenses?

[madinmaryland]

6. This...

• All office visits
• An annual physical examination
• Lab work only related to and required by the annual physical examination.

And they will probably be spending more time at the specialist than the internist or GP. :wtf:

[lizerdbits]

7. He doesn't have a flat annual fee though, I paid per appointment

and he's a specialist, so it's a little different. If he wants blood work he would would give me the sheet for whichever place my insurance took. My current insurance will cover 80% of his appointment since he's 'out of network' but if you have a shittier plan than I do that could be zero.

[madinmaryland]

9. Basically you have to pay this guy $2,000/person up front, and then

you can submit to insurance company for each of the visits to the doctor you make. So you make six visits to teh doctor and the insurance pays $75 a visit, i'll be getting really screwn.

[lizerdbits]

10. Sounds like a great deal for

hypochondriacs with no insurance. If you need something other than what your GP can provide, you'll probably be going to specialists so it's kind of pointless.

[madinmaryland]

11. Our thoughts also. With 8 or 9 specialists involved in our lives, we need what

the insurance covers. (They do cover Chiro's :scared: ) We may see the specialists only once or twice every year or two, but you never know.

If we didn't have insurance, well... no specialists and only the sporadic visit to teh doctor.

[KamaAina]

2. This guy is gonna be in a big, big hurry soon

'cause he won't have any "patients"! :rofl:

[madinmaryland]

3. My thoughts too!

[LeftyMom]

4. Considering that I've only required more than $2K worth of health care two years of my twenty seven

And in both cases the expensive part was hospitalization and not in-office care, I wouldn't touch this with a ten foot pole.

Even for those with no health insurance, $2K is more GP visits than most people could possibly need in a year. If you're that sick, you start going to specialists, and getting diagnostic tests, etc.

Anyhow, his pitch seems to be "pay up and my office's customer service will suck less" and I'd hate to encourage that kind of business model.

[madinmaryland]

5. His pitch really pissed me off. He's been a thorough doctor, but this is

just bizarre. I know the insurance companies are trying to screw them, but this is just f'ed up.

We have insurance and co-pays for the two of us totalled less than $200 each of the last four years.

:shrug:

[triguy46]

8. This can be a very good deal...

if you have better (immediate would be the standard) access. I have a couple docs who work for me who are considering this.

[KT2000]

12. Local clinic tried this

and they have gone back to the old way.

Most doctors are probably fed up with insurance comapnies ruling their practices but they are wasting so much of their power. Instead of taking their frustration up the food chain they turn around and dump on the patient population. They do not take political action themselves as a rule, so they want the patients to do all the fighting for single payer.

[Jamastiene]

13. Sounds to me like a racket to get an extra $2000 per person per year.

If they have your insurance information already, they can charge you AND still file for your insurance and get paid double. I'd find a different doctor.

[ThomCat]

14. I know some corporate executives who go to doctors

who do not accept insurance. It's apparently very nice for the people who can afford it. Instead of fighting to fix the insurance system, more and more doctors are simply opting to only serve wealthy patients.

So much for "do no harm." x(

[Tuesday Afternoon]

15. weird ways and strange days are upon us, I fear.

Picky, I know but the last sentence is odd to me "and you _____willing to torpedo"

I am interested in what, if any, response you get to this.

[FloridaJudy]

16. I have no insurance

And my doctor kindly charges me $90 dollars a visit. I'd have to visit her 20 times a year for this to make sense, and while I have some health issues, I'm not that sick! Since this doesn't cover prescriptions, hospitalization or specialists, you'd still be in a deep financial hole with just one severe acute illness. Something catastrophic would bankrupt you entirely.

No thanks.

[BlueIris]

17. I first started reading about so-called "cash only" practices in 2003.

One example I read about was a GP in Cleaveland who stopped accepting insurance. He said he lost $40,000 dollars in revenue per year after the switch, but was still happy he'd done it. I don't remember how long he'd been "cash only" at the time the article I read was written.

[pitohui]

18. obviously you have to get another doctor

you have to pay $2K a year for this doctor and then you need an oby/gyn and then maybe you're in an accident and you need a surgical team and then...???

this is just theft, pure and simple, you can't pay $2K PER YEAR to every doctor and surgeon that you might possibly need in the course of a year

i think the real point is the doc doesn't want you as a patient and it's his little hint and the letter is a waste of energy but let us know if he actually makes an exception for you and continues to take your insurance

[madinmaryland]

19. I don't know if it's that he want to get rid of us personally, but he does want to reduce

the total amount of patients. He currently has 3,000. I'll see what happens with the letter.