Friday, May 4, 2007

One odd medical issue

A man came in today with valid insurance. He had called 3 or 4 other doctors' offices for appointments. Although other offices accepted his insurance, he was told they were not taking new patients with his plan.

When he called our office we "gave" him an appointment. It took us 20 minutes to figure out how to bill his insurance plan (we 'll find out in 90 days). The main reason we gave him an appointment is that he was wheezing really loudly on the phone and he said his blood pressure was high. This seemed urgent.

When he got here we noticed he had trouble breathing, so we started treating him before we got all of the paperwork done. We have a policy here that if someone isn't breathing well, we should do some doctory-like stuff. He was very happy with our service. I simply saw a sick person who had valid insurance.

This has been happening about once or twice a week for the 3 months I have been open. Sick people can't get appointments to see a primary care doctor- even when they have a primary care doctor, on the day they are sick.

Maybe I'll look at this differently when (if) I've been in business long enough to have a full schedule and employees that were not in my wedding as the bride. But isn't it weird that sick people can't find a doctor, even when they can pay the bill?

1 comment:

Frank said...

This is not odd at all, but commonplace. It is part of the reason people overuse the ER for simple "emergencies" that would be better cared for by their primary doctor. As noted in your prior blog, you HAVE to see a certain number of patients to break even. That is defined by how much you make on each one (hopefully) and how much you plan on taking home and spending on various overhead. As overhead goes up (staff, malpractice, etc.), your NNT (number needed to treat) has to go up. Eventually you run out of time, so you feed the cycle by working more hours or hiring more docs (wash, rinse, repeat). It is inheirent that a busy practice won't have too much time for acute visits. We try to get by this by making most visits "same day", emergencies or not. People call for whatever, we get them in today. It is hard to have a fairly open schedule at the start of the day, but it fills quite rapidly since we know the patients are out there and will call.
As for the insurance thing, who cares? He needs treatment, so he signs a waiver on the way in that his insurance will be billed, but he will be responsible for uncovered costs. Cash money talks. Don't let insurance dictate what you can do. Besides, you are billing the insurance as a favor to the patient. People don't realize this and expect this service.