Ask The Expert - Florida Neuroscience Center Blog

If you were an expert corporate consultant and you were brought in to help fix a significant problem, would you allow being pushed to do this in a few minutes? Even prominent professors are teaching future business administrators that physicians can create positive relationships with their patients in a minimum of four minutes. In the era of social networking, nobody even spends four minutes communicating with someone on Twitter, Facebook or LinkedIn. Imagine if you had a problem to discuss and resolve. In an ideal world, most doctors would prefer to take time meeting their patients, establishing a meaningful doctor-patient relationship and learning about their patients without feeling rushed or needing to fill out countless forms that have nothing to do with patient care. Automated systems such as electronic medical records can help improve the overall operation and substantially reduce inefficiencies; however, many doctors pay thousands of dollars in installing these systems and making them work. In the end, this adds yet another expense on the practice to provide for information required by a bureaucratic system that doesn’t necessarily help provide quality care to patients served.  It’s not unlike spending millions of dollars to invent a ball pen that will work in zero gravity rather than using pencil and paper.

There are many good doctors who offer their services through health insurance companies. A number of patients frequently decide to drop the insurance as the insurance puts pressure on their practice.  Most of these insurance companies have carved out mental health care services or minimized services and resources. More so, with the approval of the Mental Health Parity Act, insurances are scrambling to see how they can restrict access to the care they now have to be able to provide. These kinds of restrictions are the ones that have led many good doctors to practice out of network, without any formal association with the insurance industry. For instance, many people seem surprised when hearing a psychiatrist offers psychotherapy in addition to medication management. Only 10% of US doctors offer integrated psychotherapy and psychopharmacology and most offer these services out of network. Insurance companies started reimbursing psychiatrists who offered psychotherapy less and less and they are more open to reimbursing other practitioners in lieu of psychiatrists.

While some physicians established a hybrid model, charging patients for a yearly membership fee that provides them for direct and quick access while charging their insurance for medical-related visits and diagnostic services, other physicians have opted out from working with insurance companies altogether. Some insurance companies have stopped working with some physician networks also.  While most doctors are really concerned and interested in offering their services to the population at large, many others have burnt-out after rising overheads to solely sustain insurance-related paperwork, unpaid time dealing with these same insurance companies to pay for the medications that they have prescribed, calling in to approve for diagnostic services for patients, and covering for skyrocketing malpractice insurance fees. Good doctors spend hours on the phone helping their patients get prior approval for procedures or medications they have prescribed in their patients’ best interest. Their time and their staff’s time to do this is unpaid and unrewarded in any way. Depending on how soon the doctor and his/her staff make the calls, the sooner the patient will be able to have the diagnostic tests or medications prescribed. The reason behind this on the insurance end is to ensure that the doctors don’t “abuse” the services. Most doctors don’t make any money out of their patients having their diagnostic procedures for the correct diagnosis or taking the medications they need. All good doctors want their patients to regain their health and be well as soon as possible.