I will be taking many insurances until November.
I studied long and hard to become a doctor. For some reason it appears getting a job with an insurance company has become an acceptable method of being allowed to play doctor. Back in the day this would have been malpractice. Somehow insurance companies have been allowed to prevent chiropractors from making decisions and care recommendations. Our diagnoses and care plans are at the mercy of the patient’s insurance. How did we get to this point?
In 1976 four doctors of chiropractic filed suit against the American Medical Association (AMA). Chiropractors charged that the AMA attempted to “contain and eliminate the profession of chiropractic” via a systematic and premeditated plan. This sounds outlandish today, but after 11 long years David slew Goliath. In 1987, United States District Judge Susan Getzendanner found the American Medical Association (AMA) and its codefendants guilty of violating the Sherman Antitrust Act (A. Wilk et al. v. AMA et al.). The AMA lost in its attempt to eliminate chiropractic competition. Thus began the golden era of chiropractic insurance coverage.
What began as an era of no copays and unlimited visits slowly morphed into today’s parody of actual coverage for your investment. At the same time autonomy was slowly ripped from the hands of the poeple who should be decision makers (based on who has the medical degree) and given to paper pushers. Doctors gave up independence and had it replaced with stress, frustration, aggravation, and the necessity of navigating through ever-increasing time-consuming layers within the insurance companies.
I will still see insured patients and they may choose to submit their receipt to their insurance carriers for reimbursement. They will be treated exactly the same with the same comprehensive documentation. There is nothing about being an in-network doctor that equals better care.
Medicare is a whole other issue. I believe chiropractors are the only segment of doctors who are forced to treat Medicare patients. Please note, however, that although Medicare requires exams – THEY DO NOT PAY FOR EXAMS!!! How is that for getting your money’s worth? Also be advised that if you need to have an extremity treated – MEDICARE DOES NOT PAY FOR EXTREMITIES, OF FOR WORK ON THE MUSCLES, OR A LASER TREATMENT IF NEEDED. Regardless, if I do any of these extras I am required to charge you for them. In other words, in most cases a patient is better off paying cash at the time of service.
Coverage for chiropractic becomes more limited, with more reviews, lower and declined reimbursements, and more denials every year! I don’t want to live in a backwards world where insurance companies dictate what I can do on behalf of patients. The time has come to stand up against the wicked witch. Please understand that medical care is largely sickness care. My work is wellness care, designed to rehabilitate your nervous system in order to optimize your life’s functions. I sincerely hope you will explore the option of cash pay and see if truly is better for you.
Doug deVries, DC says
Dear Doctor,
How are you handling the transition thus far ? I am in the same boat with an additional issue of a PGIP that takes 15-20,000 a year from the reimbursement fee. With insurance I feel it a race to the bottom.
Yet another way the insurances like BCBS keeps reimbursements down. Meanwhile all hospital affiliated physicians get educational loans forgiven for working at a non profit hospital. I want to go private as soon as I can. I have several cash patients at 50 a visit.
Dr. Pat Dougherty says
Hi Doug, Amazing what happened. Very few dropouts from the practice. The energetic vibe escalated and I believe that affected business positively. I pretty muxh immediately started being more busy. Now 8 months later I am busy to the point, for the first time ever, I am having to postpone new patients for weeks. Oddly, patients seem to be listening to me better also. Wish I had had the guts to do this years ago. Plus it feels good not to support the scams that are insurance and the medical industry.