Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Friday, August 25, 2006

What should I do?

Starting September 22nd, the government will not be sending out Medicare payments for nine days. (Really.) No interest; no late fee; no nothing. Just no checks.

What do you think would happen if I just decided not to pay my office rent until the 10th of the month when it's due on the 1st? What if I didn't pay my electric or phone bill? Do you think the credit card company would bat an eye if I dropped them a note telling them my September payment was going to be nine days late and not to bother charging me extra? Do you think pigs can fly?

My landlord would be at my door daily; my phone and electric would probably be cut off after a week (a bit of exaggeration given my stellar credit rating) and the credit card companies would cheerfully ignore my protests that I had told them all about it ahead of time.

So it would appear that in the world of business, service stops when not paid for. I can do that.

Between September 22nd and October 1st, I will refuse to see Medicare patients in my office. If they need care urgently, they can go to the ER. I shall also tell them exactly why I am imposing a moratorium on caring for them. And if (when?) this happens again next year and the year after that, I'll just be that much closer to the brink of opting out of Medicare entirely.


At Tue Aug 29, 08:25:00 AM, Blogger M. Dyspnea said...

I'm still so far away from having to deal with these types of problems and I just keep hoping that more and more people stick to their principles like you're doing here. Try to have the whole medical reimbursement issue handled before 2015, if you could.

Best of luck, topher.

At Fri Sep 01, 05:36:00 PM, Blogger ismd said...

I'm doing the same for those days. It's shameful that many of our colleagues have an "oh, well" attitude about this.

At Sat Sep 02, 11:23:00 AM, Blogger yuri said...

If you are simply making a statement, fine don't see patients those 9 days.

If you want the fiscal solution, you would have to not see patients for a nine-day-period starting about 3 weeks before the payments are to be withheld. This allows you to fill your schedule with patients with insurance that pays "on time". Ultimately you will be paid for seeing these medicare patients just up to 9 days late.

The sad irony is that if you filled said schedule with Blue Cross/Blue Shield or United Healthcare or Cigna patients for that 9 day period, those a-holes would hold your money for even longer in most cases than the federal government is threatening to hold it...

My solution has been to drop all insurances (aside from medicare) and I am much happier. I just wish others would do the same.

The following is a quote from Atlas Shrugged, a work of fiction published in 1957. While the author Ayn Rand was referring to government controlled medicine, the same scenario is true for HMO and insurance company control. The final sentence is particularly potent.

I quit when medicine was placed under State control, some years ago, said Dr. Hendricks. Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward.

I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything except the desires of the doctors. I have often wondered at the smugness with which people assert their right to control my work, to force my will, to violate my conscience, to stifle my mind. Yet what is it that they expect to depend on, when they lie on an operating table under my hands? Let them discover what kind of doctor their system will now produce. Let them discover in their operating rooms and hospital wards that it is not safe to place their lives in the hands of a doctor whose livelihood they have throttled. It is not safe, if he is the sort of doctor who resents it, and still less safe if he is the sort who does not.

At Wed Sep 13, 03:10:00 PM, Blogger #1 Dinosaur said...

I agree, Yuri. Cash only is my ultimate goal, approaching inexorably. I'm just not sure what's going to actually push me over the edge, though.


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