10/05/2024    Robert Kornfeld, DPM

It’s Time to Unionize (Jeffrey Kass, DPM)

I think it is an absolute travesty that as the
years went on, podiatrists have been paid less and
less. I agree with Dr. Kass that something must be
done. However, it is my opinion that a union will
have only limited success because insurance
companies will still retain the power of payment.
After all, they collect the premium dollars. They
don't want to share that money with doctors. You
can go on strike, but you will be limited to the
power of negotiation and the amount of money that
insurance will be willing to let go of.

There is a movement (finally) in medicine back to
private practice/direct-pay models. I am friendly
with many MDs and DOs who are leading the charge
away from insurance-dependency. And amongst MDS
and DOs it is a rapidly growing business model.
Why would anyone do this? Because you become
autonomous and make all the decisions. You can
practice according to a medical standard of care
rather than what the insurance companies let you
do. You are free to set your own fees.

With a direct-pay model, you can make an amazing
living on 8-10 patients daily. You don't need a
big office. You don't need a big staff (I actually
have had no staff since 2014). Your expenses drop
astronomically. When done right, you will make a
better living than you can seeing 40 patients or
more a day on insurance. The doctor-patient
relationship grows deeper and more potent.

If you are currently employed, you know your
salary is not based on production. When you are
direct-pay, production increases will increase
your income. The time for the mutiny is here.
Without your participation (cooperation) with the
madness, insurance companies have no power and
will not be able to interfere in what you deem
prudent for your patients. I've done this very
successfully for 24 years. It not only works, it
has blessed me with a stellar professional
experience.

Robert Kornfeld, DPM, NY, NY

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