I am self employed and opt to not carry insurance except for my youngest son who has cystic fibrosis. Reason being, I needed the help with his prescriptions which were running me on average 5K out of pocket per month.

My primary care physician does not take any health insurance plans and is a cash only business. I LOVE IT. I do not have any problems being seen, I don’t need to ask for permission to have tests run…and generally have no problem negotiating cash fee rates for tests (lab/xray).

Medicare reimbursement never seems to be enough and it seems to be a game of sorts that Dr’s. have to play with regards to documentation. I know it was done, you know it was done…but it has to be documented in a certain way in order for you (the Dr) to get paid for it.

Gah!

Thank you for a great blog and for this one in particular.

for newer listeners at home, “IMP” stands for “ideal medical practice,” a movement dr ferenchak and i are both part of. ideal medical practice embraces ideals of high accessibility and medical excellence, employing high technology (for example, electronic medical records and e-communications) to maintain low overhead costs that enable us to deliver “care that matters” to patients. see http://bit.ly/wGNyM for more.

Outstanding and troubling expose on reimbursement. Got to you through IMP listserve and appreciate your effort and your caring.

I’m a retired surgeon finding it necessary to return to medicine and plan to start an “cash only” IMP doing monor surgery and primary care. Your comments support my “cash only” plans and it will be well worth the decrease in patient contact fee to eliminate the insurance issues. Just reapplying (considering it) for Medicare is a daunting and time consuming effort.

I’m amazed that with all the discussion on “reform” I have not heard once the introduction of IMP as a solution to the crisis. It seems to me the only solution.

Thanks again,

Paul