The Cash Only Practice of Medicine

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Some doctors are attempting to find ways to make a living and provide appropriate healthcare to their patients

Doctors, while making up an important segment of the healthcare system in the United States, are not mass produced widgets. They are individuals, some of them specialists, who have spent thousands of dollars getting trained over hundreds of hours of training. They are not products they are people. When the powers that be attempt to make changes to the American Health Care system they seem to be approaching these changes as if the disparate parts of the system are interchangeable, cogs in the system, as it were.

Doctors are as concerned as any other part of the healthcare system to see what the politicians and pharmaceutical companies and insurance companies do to try to “regulate” the healthcare system and “organize” it for delivery of services. They need to be an integral part of the decision making process regarding health care services and policies.

Some doctors are taking matters into their own hands and attempting to find ways to establish themselves in a position where they can make a living and provide appropriate health care to their patients. Today we are going to examine some of the reasons this is happening and some of the strategies that physicians are using to solidify their role in the provision of health care to patients and their ability to earn appropriate recompense for doing so. Many doctors are learning that they need to take care of themselves or they will be swallowed up by the needs and demands of other parts of the healthcare system.

One such strategy that doctors have learned to utilize is the development of Concierge practices. These are practices that are not dominated by the insurance system or controlled by the hospitals, nor limited by the power of the pharmaceutical industry.

A new approach that has evolved out of this Concierge strategy is the development of Cash Only practices. Doctors are saying to their patients  “I will treat you for this and it will cost you “X”. They do not go to the insurance companies for permission or negotiate prices for the intervention, and they do not deal with the drug manufacturers. My relationship is with you the patient, and not with these other entities. These Cash only practices are still regulated by the Federal and State Governments regarding licensing, OSHA, HIPPA, and all the other alphabet agencies of the government. But the real advantage to both the patient and the doctor is that the patient knows what he/she is getting, and the doctor can spend her time providing care in the way she believes it needs to happen. The insurance company does not get to tell her what is “standard” or that the drugs she wants to prescribe for you are not in their formulary, so they won’ pay you for it, they just write the prescription they think is best for you and your circumstances.

One of the benefits to both sides of this approach, is that doctors are able to determine the average cost of the things they treat, such as a knee replacement, or a stint for the heart, or cataract surgery, etc., these doctors can then advertise their prices and individuals can comparison shop and negotiate for better prices. Those involved in the Cash only system are able to benefit from economies of scale without having to pay for the overhead of the insurance industry, for the hospital costs of equipment and staff that these clinics do not need to have and they can pass those savings along to the patient! Everyone wins except for those portions of the population that are too poor to be able to pay cash for these procedures, and those portions of the population that need more comprehensive and complex global treatments that would require a hospital or a complex cluster of treatments that would not fit within the scope of the individual Cash practice.

As you watch our Healthcast we hope you will be stimulated to think about how the healthcare system needs to change and adapt and share your thoughts with your doctor and with your political representative!

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.  

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