From: David E. Samuel, DPM
On target once again Dr. Jacobs. Making a good living is one thing. Daily fighting with insurance companies, etc. can suck the life out of you. What we do is rewarding. The daily grind to achieve that and make a solid living gets worse. For my 3 boys, there is absolutely a better way to make a living than the energy expended on non-patient care. I would not recommend [podiatry] unless this was something they absolutely were hard fast and committed to in medicine; and then if would be allopathic for sure. None have chosen medicine, although one took his pre-med degree and decided on device sales and will continue to do quite well.
The parity thing is funny. Parity how? I don’t feel any less than any of the doctors I work with and who refer to us. We have mutual respect and...
Editor's note: Dr. Samuel's extended-length letter can be read here.
From: Tom Silver, DPM
I completely agree with Dr. Gerald Peterson's statement that "Medical treatment should always be in the best interest of the patient, regardless of insurance coverage". Unfortunately, we often make the mistake of a preconceived decision regarding what a patient can or can't afford and either offer a lesser option, such as pre-fab inserts when they really need Rx. orthotics or only provide services that insurance will cover and not even offer non-covered alternatives that could help them.
I also feel that a certain percent of the time we tell patients that something isn't covered and they reject part or all of our recommended treatment for something they truly need. They respond with the famous words, "If it isn't covered by my insurance, then I done want it." This is often because of our failure to properly present the non-covered service to our patients so that they understand that this will take care of their foot problems and address their concerns.
Whether a patient has insurance or not, it's really frustrating how much treatment we don't provide to our patients when we don't listen to their concerns. We don't present treatment plans in an organized way that they would gladly accept. Dentists are masters at getting patients to go along with a treatment plan, regardless of cost. A colleague recently complained of a patient who said he couldn't afford to pay $400 for the orthotics he needed because he was paying off the $12,000 owed to his dentist!
Tom Silver, DPM, Minneapolis, MN
