I may not accept your insurance, but I will always accept you

Accept Insurance:YOU

Just for the record: I am happy to see you—irrespective of your insurance.

I accept most insurance plans. And if I don’t accept your insurance, I have a very good reason.

I will not sign a contract with a health insurer that:

Abuses and bullies me and/or my patients.

Denies all my first claims.

Reimburses me so little that I may go out of business.

Leverages a $50 penalty against me when my patients accidentally go to out-of-network labs.

Charges me hundreds of dollars of “membership fees” before I’m allowed to see their patients.

Offers me a contract that dictates my responsibility for THEIR legal fees if they determine I did something wrong.

Keeps me on hold and rotating through multiple phone lines while never addressing my concerns.

Treats me like a criminal.

Assigns me patients who have not selected me as their doctor.

Pays me through a complex formula that even a mathematical prodigy can’t understand.

Penalizes me financially if I don’t use the type of computer system that they think I should use.

Penalizes me financially if I don’t electronically submit my prescriptions the way they think I should.

Threatens me and my colleagues every year with all sorts of financial penalties if we don’t do what they (non-physicians) think we should be doing.

Insurance companies have done all of these things to me. My choice to end my relationships with abusive insurance companies will never impact the quality of medical care that you’ll receive from me. I will always care for you even if I do not care for your insurance company.

Just saying.

Pamela Wible, M.D., is a family physician who pioneered the first medical clinic designed by patients. Watch her TEDx talk on ideal medical care. Photo by GeVe.

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25 comments on “I may not accept your insurance, but I will always accept you
  1. Nu Neteru says:

    EXCELLENT!!!

  2. Rosei says:

    Amen.

  3. tad hominem says:

    marvelous summary ! I’m in love. when I retire I’m moving so u can be my doc !

  4. SteveofCaley says:

    Thanks, Pam!
    If I was an awful, skin-flint JR Ewing president of an insurance company, here’s what I would do:
    I would treat the doctors kindly. Not because I had a shred of decency or humanity to my own instincts, but rather, humanity is the scalpel’s edge of medicine.
    There is NOTHING in medicine with a cost/benefit ratio like a good primary care doctor seeing a patient. The doctor has put in a half-million dollars worth of training; and they see a patient for $20. reimbursement in a ten-minute slice. I’d insist that appointments be no shorter than 1/2 hour.
    You figure, a decent CT machine costs well over a half-million dollars, and a CT costs well more than the sixty or so bucks a doctor gets seen for seeing a patient for a half-hour. What’s the cheapest?
    I’d encourage talk over testing. Talk is free. Help focus testing on what is needed AFTER a half-hour visit. Many problems can be diagnosed and treatment begun in the half-hour talking session – no MRI’s.!
    I’d spend money to foster the doctor’s humanity and wellness. Again, not because I have a shred of empathy; but healthy and empathetic doctors save money.
    I would track outcomes. If wellness retreats for doctors saved me more money than they cost, I’d underwrite wellness retreats, and anything to humanize and care for the doctors’ decency. Remember, I’m a flinty-hearted businessman – I’ll do ANYTHING for money.
    It’s the lazy CEO’s who don’t get this. Saving $40 in a crowded clinic winds up with spending $2000 in an ER visit, that is unnecessary and wasteful. And doesn’t help the patient.
    Greed is good – our current system is as stupid as a child’s tantrum. Throw the tools on the floor, dull that scalpel and break that light – see! I taught that scalpel, that light, that retractor, a LESSON! How childish.
    Doctors are instruments for rational use of profit-taking. They are empathy machines. Why damage them childishly?
    —-
    Well, I’ll wash the Gordon Gekko out of my mind, but even the harshest insurer should get it – why don’t they?

  5. Marv Brilliant says:

    To all insurance companies: Stay the hell out of medicine!!

  6. Geoff says:

    Great article, Pamela.

    It’s tempting to name the offending companies, but doing so could result in legal action, so I won’t.

    I believe as we, the insured, become aware of and speak up for human dignities for ourselves and our physicians, there will be changes, i.e., unhealthy health insurance companies will change their ways or we’ll take our business to those who ARE healthy.

  7. Sheila Larson says:

    Thanks for informing us. Wow. That is so ridiculous and glad you educated on the scam if it all.

  8. Lorin Loomis says:

    We need the majority of doctors to have the courage, integrity and education to refuse to be bullied by the insurance companies. This would go a long way in making right what is currently wrong with our healthcare system.
    Thank you for stepping up, Pamela Wible MD

  9. Debberdoo says:

    What a tangled up nightmare. So, now I’m beginning to understand the high suicide rate among doctors. Doctors are the filling inside a sandwich being squished flat while their sensibility is sent to the outer edges and beyond.

    Pamela, thank you for all you do, in helping me and countless others make it through the rabbit hole.

  10. Melody Carr says:

    Can we just pay you a set amount per month as a wellness membership and skip the insurance companies’ premiums?

    • Pamela Wible MD says:

      That is a legal way to set up a practice. My clinic still accepts (most) insurance and the majority of insurance companies do not bully or mistreat doctors. It is (like much of life) the few bad apples that ruin things for the rest of us. There are clinics that accept a yearly or monthly fee that covers all medical care. There are others that have the yearly fee AND bill insurance or patient per visit. But the majority are fee-for-service like most other businesses where you pay per service. As a business owner I favor the pay-per-service route. I do think primary care would be cheaper without all the middlemen and that patients should be able to choose who they want to see and for how many visits without limits. Insurance (like car and home insurance) should be for catastrophes and not routine oil changes or appliance problems. My favorite analogy: If you hired a third party to pay your restaurant bill, you’d pay twice as much, wait 2 weeks for a table, and have 7 minutes to eat. This is what we have done to primary care. We’ve taken something relatively simple and made it complicated (and costly) beyond belief.

  11. Butch says:

    I am still stuck in limbo unable to get pain treatment because doctors here in Texas are to afraid of losing licence. If I flew up there with proof I need this would you be able to help me?

    • Pamela Wible MD says:

      I could refer you to a great pain doctor here, but I am not able to take on new patients at this time and it’s obviously always best to find a doctor in your area. I hope you checked the map on my site. Keep checking out the local docs. If you want to move to Oregon, I’ll help you get set up with someone.

  12. Robert says:

    So you will accept a patient with no ability to pay? Given that in Cincinnati, where I live, my primary care physicians is reimbursed by insurance at $275 per visit, then charges me an extra $20 because his real fee is $295 per visit (and this after my $25 co-pay). Let’s be generous and say he spends 10 minutes with me (it’s actually less). That’s 6 patients per hour multiplied by $320 so he makes $1,920 per hour, or $15,360 for an 8 hour day, or $76,800 per 5 day week. Exactly how much do you think a doctor should earn?

    My liver specialist charges $750 per visit after my $50 co-pay, plus another $50 “facilities fee” that I must pay. You can do the math yourself on that one.

    Of course, none of those fees include lab tests, CT scans, drugs, etc. Those are all extra.

    In Kentucky, where I was born and raised, several large hospital chains and cardiologists were just indicted for billing Medicare for unnecessary medical procedures. Hospital and doctor billing fraud are rampant. Certainly you’ve heard of Columbia/HCA, which was fined $1.7 Billion in 1997 because of their rampant Medicare fraud? That’s just one chain of hospitals and doctors.

    You refuse to accept tax payer funded Medicare, even though the medical schools that educated you are supported directly by public tax dollars and student loans guaranteed by the tax payers? I won’t even bother to ask if you accept Medicaid – how do you propose those indigent people afford health care?

    It’s the arrogance of comments like, “I love old people but I won’t accept Medicare,” that create such distance and disdain toward doctors.

    • Pamela Wible MD says:

      I never turn anyone away for lack of money. We all make choices. I choose not to be abused. I also choose to care for the people who come to me seeking my services—regardless of their ability to pay. Helps me sleep at night knowing I did the right thing. I can not control the ethics of other people or other systems. I am responsible for my little footprint on the planet.

  13. Anne Haller says:

    Dear Dr. Wible,
    From your website, you sound like a dream come true. I moved to Eugene recently from Southern California. I am struggling to find a primary care physician as not many are taking new patients. I have Blue Cross/Blue Shield and Pacific Source insurance. I am a 55 year old female and had back surgery in Dec. 2011. I am having some pain so I am thinking I need an x-ray. Are you accepting new patients?

    Thank you,
    Anne Haller
    bunkybubbs@sbcglobal.net
    714-328-1958
    541-735-3129

  14. Jen says:

    Hello Dr. Pam,

    Being an RN with experience in both impatient and clinic care, I wholeheartedly agree with the majority of your views on Medicare and Medicaid. My inquiry (and angst) involves Press Ganey. What are your thoughts about this company and how their survey results directly affect our hospitals and in hospital clinics?

    • Pamela Wible MD says:

      Jen ~ Disintermediation = removing the middle man. One of the BIG problems in health care is too many third parties that are meddling in the doctor/nurse-patient relationship. We need to be left alone to do our jobs not kowtow to big corporate machines that pass out scaled survey questionnaires. Hospitals should go directly to the people and ask what they want and then deliver. No need for anyone else in the room. Check out what one hospital did here –> http://www.idealmedicalcare.org/town_hall_meetings.php

      What do you think Jen?

  15. Carl says:

    Yes!! You have restored my faith in medicine. It is very refreshing to see a physician who takes a stand against the tyranny of the Medicare system.

    • Martin contreras says:

      Mds should take a bussiness semester classes so they can eliminate out of the medical bussiness abusive medical insurance companies. Foeever.

  16. Jeanne says:

    I don’t understand why if a person has Medicare coverage, but the Doctor doesn’t take Medicare so the patient offers to pay cash the Doc’s say they still CAN’T see you, because if you have Medicare you have to go to a Doctor that takes Medicare. I had that happen to me several times. Tell me how do I get around that road block?
    Thanks.

    • Pamela Wible MD says:

      Doctors have to OPT-OUT of Medicare (a bureaucratic process) in order to legally see patients for private contract (or cash).

  17. Megan Berryhill says:

    Dr. Wible, can I (as a physician) register with Medicare to just prescribe and refer (not bill for services) and then legally charge Medicare patients my cash rate? I don’t want to accept any kind of insurance, but I’ve been told that means I cannot treat Medicare patients for any charge.

    • Pamela Wible MD says:

      I have opted out of medicare and treated Medicare patients for my cash rate for years and they have had no trouble getting their medications or lab, tests, etc . . .

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