06/29/2023    Robert Kornfeld, DPM

Ability to Have a Concierge Practice (Steven Belanger, DPM)

Dr. Berlanger asserts that, "Not everyone has the
ability to have a concierge practice or a holistic
practice that does not participate in any insurance
plans if someone practices in a relatively low
income area". Dr. Berlanger - that is simply your
own belief. As adults, we have freedom of choice.
No one is a victim of circumstance to their own
prior decisions. I started my career in a
relatively low income, blue collar town. And when
it worked for me, it was great. But I had bigger
aspirations than to sit around watching self-
serving insurance companies whittle away at my
income. I was very lucky because insurance
companies and Medicare way back in the 90s began to
target my practice and deny claims for anything
they considered "holistic". So I developed a
"hybrid" practice before I ever heard the term.

Yes Dr. Berlanger, even in my town, people were
willing to pay me directly for those services.
Sometimes the same people that refused to pay co-
pays or deductibles. And many came from a distance
to see me for those services. But I saw the
trajectory. The insurance-pay side of my practice
was earning less and less and I had to see more and
more patients yet, at the same time, for far less
effort and expense, the direct-pay side had much
greater earning power. So I picked myself up (I was
raising 3 children at the time) and moved my
practice to a neighborhood about 15 minutes away
that was a higher income area. And I dropped out of
all insurance in 2000.

After a year of adjustments and a lot of marketing,
it started to take off. My point here is if you
stay where you are because of a belief or fear of
change, you are going to be working harder and
harder for a lot less income with a lot more
hassles and administrative challenges. After 69
years on this planet, I can tell you that
everything you settle for will leave you reeling in
a state of disappointment and lack of fulfillment.
Then life slips away and you become bitter. I
assert that those who "do not have the ability to
have a concierge practice or a holistic practice
that does not participate in any insurance plans"
are making a choice to do so. You CAN make a
different choice.

Robert Kornfeld, DPM, NY, NY

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