I would like to take an opportunity to respond
and further clarify my position in my earlier
post for Dr. Kornfeld. In no way, would I
advocate that any practitioner, or business
owner for that matter, routinely be cavalier
regarding whether one gets paid or not for their
services, if he intends to remain in business.
The solution is quite simple, the decision to
provide treatment procedures for a patient
should not be contingent on the where the source
of payment will be coming from. It is not the
practitioner who is responsible to routinely
write-off services that are not covered by
insurance carriers. In fact, I feel that it is
the responsibility of the practitioner to advise
when an insurance carrier will not cover a
service and to educate/inform patients to file
complaints/appeals when such services are denied.
To further protect himself, he should routinely
obtain Advanced Beneficiary Notices on private
and Medicare insurance plans that are expected
to deny such services provided. It is his
responsibility to explain why such service is
required and that such payment will not be
expected from his/her insurance carrier, but is
expected from the patient.
In regard to Dr. Kornfeld's contention that
there has been a "downgrading" of the field of
podiatry in front of the APMA. I can personally
assure you that upon speaking with my brothers,
one a pediatric dentist and the other a retinal
surgeon, the American Dental Association and the
American Medical Association, respectively, have
also seen their members' field of
practices "downgraded".
I tend to read about much of the "goings on"
outside the field of podiatry concerning
healthcare issues currently and in the future.
For example, I just read a story link on the
AMA's Facebook how "excited" and "thrilled" they
were as an organization that the vast majority
of ACO's (Accountable Care Organizations) formed
were physician "owned." And yet, I also remember
reading Dr. Paul Hamlin's editorial message on
the Nassau County Medical Association's website
on how the Medical Society of the State of New
York and the Nassau County Medical Association
were against such "schemes" (his word within the
editorial) on such methodology of reimbursement
that was intended to limit physician income and
practice decisions. This is certainly an example
where a national organization differs from that
of the corresponding local affiliate.
My point is that you should actively seek out
any and all options you feel will best position
your practice in the future. These decisions are
best decided by the individual practitioner and
NOT one option here is the "silver bullet" for
future success. Such decisions may include
participating or not participating with certain
insurance carriers, becoming a member or
choosing not to become a member of your
national/state professional societies,
broadening the level of services you routinely
provide, in-office dispensing as an adjunct
source of service and income, affiliation with a
large hospital network within their management
network organization, forming a multi-specialty
practice or single-specialty "super group," or
securing the real estate where you practice as
an owner, etc. In my opinion,
healthcare "reform" will come, whether one wants
it or not.
In regards to the notion of "going down with a
ship," that is not a "winning" business model.
Neither is incessantly complaining also. Taking
action on matters that affect your practice,
including APMA membership, in my opinion, is
essential to guide you on the "field mines" of
future healthcare changes that are certain to
occur.
Gino Scartozzi, DPM, New Hyde Park, NY,
Gsdpm@aol.com
