Dr. Scartozzi states: "The solution is quite
simple, the decision to provide treatment
procedures for a patient should not be
contingent on 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."
This is my point exactly. Medical care in this
country has been dictated by the insurance
carriers. Medicare sets our fee payments,
private insurance uses it, and have brainwashed
patients into the concept that everything is
covered and we are they guilty parties when we
aren't. Why be put in the middle of that?
I wonder what "smart business doctors" like Jon
Hultman, David Helfman, and Hal Ornstein would
say about all your patients being on one
insurance plan? Well, essentially, that is what
we have. It didn't work out too well for the
employees at Enron, did it? All their retirement
benefits were in company stock, not diversified.
We must come up with a solution for all doctors
to survive.
The issue is the business model, not our
profession as MD, DOs, or podiatrists. It's not
how many extras we sell. It will not be totally
solved by supergroups. The latter is a key
element as there is power in numbers.
I would like any of the legal profession who
read PM News to comment on if "an organization"
can educate doctors on best practices. A model
which pursues not contracting with insurances.
There would be no negotiating or choosing plans,
only educational and organizational.
I realize the potential legal ramifications, but
this is the way over time to reverse the trend
we, all doctors created. Otherwise, as expenses
go up, and revenue per code stays flat or
decreases when over utilized, we all will reach
a point when we can squeeze no more fat out of
our practice nor see anymore patients per hour.
Oh, an then there is ICD-10 down the road. Any
responses to this should be the issue of our
business model - that is the elephant in the
room.
Jack Sasiene, DPM, Texas City, TX,
Sasiene@aol.com
