Working for the Patient vs. Working for the Insurance Company

Well that’s a novel concept, isn’t it?!? I was reading an article today in the Wall Street Journal about the rising costs of healthcare and how deals between hospitals and insurance companies are contributing to the problem. Try reading this piece… doesn’t it make your head spin? Hospitals do this and try to block that, and insurance companies do this and switch plans and so on and so on. In the end, none of these decisions and maneuvering are really about patient care. They are strictly about market share, controlling health care utilization and profits. Too much of our current healthcare system places multiple barriers in between doctors and patients. Additionally, many medical decisions now are based solely on insurance coverage and their “protocols,” and not what is best for the patient. 

​To go along with this, I received a letter from BCBS of RI last month. Essentially, they scolded me for using a specific lab company that is not “in-network” with them. They attempted to remind me that my contract with them stipulates I use only labs they approve of. This was bullying and an attempt to use their power to sway my medical decisions. I gently reminded them that as a Direct Primary Care doctor, I have no contract with them and ended my response by noting that I will do what I feel is in the best interest of the patient, both medically and financially. 

Isn’t this how medicine is supposed to work? Being a primary care doctor is not about following algorithms set forth by financial models, seeing 30 patients a day, having zero relationship with these patients and having an unfulfilling professional life. We went into primary care to establish relationships with patients, treat patients of all ages/races/genders/socio-ecomonic backgrounds, use our medical degrees to their fullest extent and feel that we are really making a difference in the lives of our patients. We also believe that patients should play a big role in their healthcare! They should have direct access to their doctor, have a doctor who knows them well (both medically and psychosocially) and be part of the shared decision making process as it relates to their treatment plans. 

Direct Primary Care, and Direct Doctors specifically, aims to do all of this. By owning our own clinic and removing the administrative burden of joining a large healthcare system, while also avoiding the rules, regulations and hypocrisy of insurance companies, we really try to simplify things down to the two key players… doctor and patient. If you’d like to see how we practice primary care differently, please check us out at www.directdoctors.org.