Jilted

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Dear patients on insurance company X:

I am very sorry to give you the bad news: effective immediately, we are no longer providers on your insurance plan.

I am sorry about this because many of my favorite patients are on your insurance plan.  It will miss seeing you.  I am also sorry because this makes your already short list of possible doctors even shorter, making it much harder for you to get good care.  There is a reason there aren\’t many doctors on your plan: it just doesn\’t pay enough to be worth it.

I suspect that some of you must feel jilted, like you just got an unexpected \”Dear John\” letter.   I hate giving this sudden bad news; I\’ve been with many of you for more than 10 years, walking alongside of you through sickness and pain, births and deaths, sadness and joy.  But what I hate the most that all of this is happening because of money; it makes me feel selfish or petty.  Please believe that we did everything we could to avoid this situation.

Here are the things that drove us to this hard decision:

  1. Your insurance was already paying us significantly less than average, and now wants to pay us even less.
  2. Your insurance also requires us to do far more paperwork than most.
  3. Their referral process is very complicated and frustrating.

As a primary care doctor, I make my living by what I get paid for office visits.  We don\’t do a lot of procedures, we don\’t see people in the hospital, and we don\’t own a lab to make us money.  The only source of income I have is the time I spend with you and other patients in the exam room.  For whatever reason, your insurer (and many others along with it) don\’t value this time.  They will pay for expensive drugs and procedures, which are many times more expensive than I am, but feel that their cost savings has to come off of my salary.

It is hard to understand why insurance companies try to save money by cutting the pay for doctors like me.  My goal is to keep you healthy and keep you away from the things that cost the most: ER visits, unnecessary labs, hospitalizations, unnecessary procedures.  Isn\’t that what insurance companies want?  If I can prevent a single day in the hospital by keeping healthy, I save more money than that you will ever spend in my office for your entire life.

One of your insurance company employees told us that accepting lower payment is somehow a \”civic duty\” for us to help keep costs down; but I wonder if it would be better to to sack a few insurance company employees who increase cost by making things harder for everyone.  No, my duty is to take good care of my patients, and increasing my patient volume to make up for decreased pay is the wrong way to do it.

This is exactly what is wrong with our system: the essence of health care is the interaction we\’ve had in my office; yet we are the ones who are being caught in the middle.  This is why things need to change: I want to see you, and you (hopefully) still want to see me, yet the system that is supposed to bring us together is now pushing us apart.

I hope that somehow this all works out and I can continue to be your doctor.  If not, it has definitely been a privilege to be your doctor.  I hope you do well, stay healthy, and please take this final piece of doctorly advice from me: avoid our messed-up system as much as possible.

Thank you for being my patient.

Dr. Rob.

5 thoughts on “Jilted”

  1. Yeah, I had that happen to me.  Stupid United Healthcare.
    So I pay my GP out of pocket.  Why?  Because she rocks, and I’m not changing doctors.

  2. Well, this is a raw time for me to read this. I got the Dear John letter from my Electrophysiologist today. I have been seeing him for 15 years and I have just completed testing that I was to discuss with him at the end of the month. I’m shattered. Realizing that there is nothing meaningful that he can do for my heart, I still feel like I’ve been abandoned. I went online and the list of EP’s from that practice is limited with only one from the office that I was seen at.  It’s a scary time for me.
    It sucks that you have to consider doing the same thing to patients because of insurance reasons. It sucks more that your patients have no control over the management of the insurance company. Usually they are the slaves of the system. I have to stay at my employer because of the insurance package so they are free to say “my way or the highway” I understand that you feel like you are getting squeezed, but it’s your patients who are in the middle of the tug of war. Probably a lot of them, like me can’t leave the coverage we have because a pre-existing condition like high blood pressure would keep them from getting the coverage they need.

    Sorry we are all in this stupid state of affairs. 

  3. JenniferDavisEwing

     My husband and I married shortly after my maternal grandmother had a stroke.  We moved out here to be closer to her, thus putting about a half hour’s driving distance between me and my GP at the time.  My then-neurologist was also in the same part of town.  One day, I had an appt with both doctors, who practiced in the same building.  I had a 1.5 hr gap between appts, so rather than drive home only to have to turn right around and come back, I arrived early for my GP appt.  I presented my GP’s office with my insurance information at the moment I arrived in his office.  More than 1.5 hrs later, as I sat in the exam room waiting to see my GP, his office manager came rushing into the room to tell me that his office “didn’t accept” my insurance.  I pointed out to her that my parents had the same insurance, and they’d been patients of his for twenty years.  Turned out that my parents had the Insurance X HMO, and I had Insurance X PPO.  My doctor (who did, fortunately, agree to see me that day, “as a favor because of the misunderstanding”) explained to me that he’d never accepted the PPO form.  He had also stopped taking new pts with the HMO form; the only reason he kept seeing my parents is that “they’d been patients of his for such a long time”.  After that experience, I was forced to find a local GP–it wasn’t worth the cost of gas and the extra driving time just so my GP could pat himself on the back about how wonderful it was that he was doing me the “favor” of continuing to see me as a patient.  I understand that sometimes things happen, and doctors have to make the difficult decision to stop taking certain forms of insurance.  My only complaint about that day is that I was never notified prior to the appt that my GP didn’t take my insurance.  When I called to make the appt, they asked for my insurance information and I gave it to them.  That might have been a good time to tell me they didn’t take my PPO, dontchathink?

  4. My family has been with your group for over 10 years. It was a tough letter to receive, but tomorrow morning I am taking my issues with Tricare to Congress and the National Military Family Association. Anyone else who reads this needs to do the same. Our husbands may fight the wars overseas, but it is the wives who fight the battles at home! 

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