As physicians, we’re often asked if we’re a preferred provider (PPO) as if this is an honor. To the contrary. All physicians are asked to join this “club.” You’re told you’ll get busier and be paid sooner if you join, but there’s a trade off. An example would be submitting a bill for $100. You’re paid $70—maybe—and the middleman cashes in on your health. HMO deals are cut all the time. We’ll pay X number of dollars for X amount of care. Now the math should step in here: an average physician usually will net 22 to 25 percent profit after expenditures.
Many of these PPOs discount the physician’s care by 30 percent to lure young businesses expecting to save money. The fact is, you can’t operate with a 30 percent loss. So if you’ve noticed, you have increased visits, X-rays, exams, therapies, etc. Is this care or a compensatory financial reflex?
If you were a physician, how would you explain to your patients the different varieties and cost of care and why one patient is paying $20 and one is paying $50 for the same care and same care technique? The patient’s care always is best handled by a physician with a passion for his work, using all his wisdom and education to better the quality of life for the patient.
A very wise old doc said to me while I was in college many years ago, “Young Doc Z, you will learn that our profession is a passion, and fee compensation is secondary. Many times you’ll be able to treat your patients with normal care, but you’ll become a confidante in his mental and heartfelt thoughts, a friend he or she needs. This is a very serious bond that allows you to be a friend, a spine mechanic, and share the knowledge that only one Supreme Being can heal.”
In one of my travels to Mayo’s, I told the administration that I noticed the original records follow the patient even years later. My question is always: how can an on/off or different doctor relate himself to the trusted care of this patient and not fully understand the patient’s inner feelings and thoughts? I’m disgruntled with HMOs and PPOs whose “let’s make a deal” attitude disrespects that long-term relationship between the doctor and patient. IBI