Did you know that 89% of primary care doctors spend less than 25 minutes with their patient per appointment. Just think about that for a second. The vast majority of primary care physicians have less than a half an hour to spend with each of their patients. And I would argue
most of those are actually less than 15 minutes. So even if a patient sees his PCP every 3 months, they spend a grand total of 1-2 hours with their primary care physician over the entire
For every two doctors in the US, there is one health insurance employee - over 470,000 in the U.S. - and you wonder why your insurance premiums keep going up?
If you take a minute to think what your interaction is like with your health insurance, you can easily understand why companies like Blue Cross Blue Shield have so many employees. When was the last time your doctor could order an MRI without having to get an official “OK” from an insurance company employee? When did you pick up your brand name medication at the pharmacy without it being denied by insurance the first time? How long did it take you to get through to the right “department” when you called to ask about coverage?
The red tape and multiple layers are there for a reason - to decrease utilization and lower costs. If doctors were able to use their clinical judgement and order your knee MRI because your injury requires it, then insurance companies would have to pay for every MRI that was ordered. By denying them the first time, many doctor’s offices are likely to say it isn’t covered and send you back to the drawing board. This means, your busy doctor doesn’t have time to work on the authorization, leaving you without the test he thought you needed. Who wins? It’s not the patient and I don’t think it’s the doctor. It’s the insurance company who successfully saved $1000s on the price of that MRI.
Lauren Hedde, DO and Mark Turshen, MD are Family Physicians and Founders of Direct Doctors, Inc. a Direct Primary Care Practice.