Why Your Medical Practice Should Stop Accepting Insurance

I went to see my dermatologist for a skin issue today.  While I normally would have put off visiting a medical clinic, I didn’t really mind.  Her office is clean and bright, her employees are happy and yes, my dermatologist always runs on-time.

Each time I have visited this particular physician, I have come prepared for the typical American medical experience.  I am pre-annoyed, prepared to for the sounds of whining children and disgruntled receptionists as I plop myself down in a worn out chair with sticky arm rests.  Pus from a leaking staph infection or snacking residue, you can never be sure.  I bring a book…or two with me prepared for the long wait until I am called back to the exam room.  While this is the scene at my primary care providers office, my OB/GYN’s practice and my former derm’s clinic, my new dermatologist operates in quite a different manner.

Upon arriving to my dermatologist’s clinic, I note the clean walls and carpet, neatly stacked magazines and smiling receptionist (with fabulous skin, of course).  She greets me but has already anticipated my arrival.  “Have a seat”, she says.  As a slide into a comfy chair sans sticky arm rests, I pull out my Kindle and dive into the novel I’m reading for this month’s Book Club.  Behind in my reading as usual, I am expecting to get through a significant chunk of my book at this particular moment.  But, one sentence into my read the nurse pokes her head through the door calling me back to the exam room.

Once in the exam room, the nurse chats with me as we discuss my latest skin issues.  She laments that she has had similar problems in the past and shows me a few photos from a book of skin products helping me anticipate the dermatologist’s treatment plan.  Then, a few minutes later the physician herself walks through the door greeting me by name.  She remembers me and the fact that she has seen both myself and my husband before.  Impressive.  She picks up right where we left off recalling where I work striking up a conversation.  The conversation flows easily to the reason for my visit as she asks me about my skin health.

Then, the dermatologists discusses my diagnosis with me recommending multiple options for treatment from conservative to more aggressive so I can make the best decision based on my lifestyle.  I make a decision and she quickly writes up a prescription directing me to the checkout desk where I pay for my visit.  Total time spent at the dermatologist on this particular Thursday afternoon?  About 35 minutes.

Why is my dermatologist’s office so different?  Is she simply not very popular?  Is she new to her practice giving her more time and energy?  Does she sacrifice her income to simply do her job better?  No.  She doesn’t accept health insurance.

It’s amazing the air of freedom a cash-paying office brings.  Imagine if, as a nurse practitioner, you weren’t bogged down by medication and imaging preauthorizations.  Wouldn’t you and your staff be happier and more satisfied with your work if you actually saw patients rather than drowning in paperwork?  How would the appearance and atmosphere of your clinic change if you could stop paying the overhead associated with billing and administrative costs and instead reinvest in improving your practice environment and paying higher salaries to reward excelling employees?

Yes, not everyone can afford to pay out of pocket for medical expenses.  But, patients can submit claims to their insurance company themselves offsetting much of the cost.  Some patients have health plans allowing them to save cash tax-free for medical costs, such as health savings accounts.  Other patients will be willing to sacrifice financially for quality medical care.  Trust me, the $65 I paid for my dermatologist’s expert advice today was well worth avoiding the time, hassle and ultimate dissatisfaction of seeing another provider.

Operating outside of the traditional medical system is a growing trend.  It gives providers freedom in decision making and eliminates the burdens associated with accepting government and private insurance plans.  More providers should consider moving in this direction.