From time to time I have an epiphany. I read articles daily. Some about sports, very few about daily news since it is so depressing, a lot about chiropractic and chiropractors, and anything that really seems interesting. Recently I’ve stumbled upon a string of articles regarding Chiropractors and the patients lives they have touched and what the doctor has done to change their lives for the better. I applaud the Chiropractors for this, and I applaud the patients for having the courage to stand up and say that they bucked the trend of “traditional medicine” and got better. Being a Chiropractor, I’m not surprised at any of this to be quite honest with you. What I am surprised about h0wever is what the patients say the chiropractor has actually done. In a lot of cases it is the furthest thing from Chiropractic out there. There are gimmicks all over the place, there are get rich quick schemes all over the place, there are things that just make my skin crawl they are so outrageous.
The problem with this whole situation is the fact that I’m on the inside. A lot of doctors don’t want people to know about some of the insider tricks and schemes and scams that exist. A lot of them the patient/consumer will never know because the insurance company will usually pay for it, and if they take care of it, then why worry about it?
Was the treatment effective? Doesn’t matter the insurance paid for it.
Is the treatment necessary? Doesn’t matter, the insurance pays for it.
Two sides of the coin, the same response. Big difference in the sides though. Neither are right, but one is illegal and one isn’t.
As a doctor you are to provide ethical care within your scope of practice, when medically necessary. Sometimes you get into an argument with the insurance companies about what can be considered medically necessary and what isn’t, which is like arguing with a brick wall, but the bottom line is what they say goes unfortunately. Once that bickering is done with, you move on and provide services that can be billed for if performed on a patient. No two insurance companies are the same, some only let you bill for certain things, some make it so you don’t want to bill for them since it can be a pain, some are extremely easy to work with, and they all can be different.
Doctors can be so desperate with things that they actually pay people to find out what insurances will cover, and at what rates. This doesn’t sound so bad until you dig into what it is. When you see an insurance company pay a doctor over $300 for a $35 TENS unit it is. Does this effect the patient at all? The immediate answer is no. But the long term answer is yes.
By shelling out $300 for a $35 piece of equipment the insurance company abides by their contract with the insured by paying for services within their scope and limits. No it also gives them grounds within the next 6 months to a year to increase the rates and premiums. A lot of people don’t understand why that happens, but it is a simple explanation. Whenever their bankroll starts to decrease they pay doctors less money and take more from the consumer. So in other words to get paid for this piece of equipment now is to take money out of your pockets later. Cutting off your nose to spite your face essentially. Only looking in the short term instead of having a long term outcome in mind. So this little piece of plastic now ends up causing you more grief than it was ever really worth to begin with, and the doctors continue their fight against “unfair” practices by the insurance company, when they are the ones causing this in the first place. It doesn’t seem so bad if it’s one doctor doing it, but in reality it is tens of thousands doing it over and over again.
The question posed now is: Would your doctor do it if insurance didn’t pay for it?
The answer is of course not. I can buy these pieces in bulk and charge only a couple dollars extra and still be ok. Or I could cut out the middle man and send you down the street to the store and get one, or send you to the internet. Both viable options, both getting the job done.
This happens a lot with doctors and insurance companies. The insurance decides to pay for something and doctors take full advantage until one day the insurance company realizes that they doctors have taken too much advantage of them and they either lower the amount the pay or they stop paying altogether. It’s a game. You need to play it to make it.
Another product that doctors like to push off on their patients are orthotics. Pieces of plastic, cloth, and rubber all put together with different ink on top and sold to people at an astronomical price. You can buy these things every day at Walmart for a relatively small amount of money, but some insurance companies will pay for ones that are “prescribed” medically for a “medically necessary” condition. Most people can feel their arches going flat, not realizing what it is actually doing to the rest of the body. They either consult a podiatrist who tells them what to get at the pharmacy or tells them it’s no big deal.
To get these from a practitioner, they write you a prescription and fill it themselves. So they then take all of the money themselves. Now these orthotics can be billed to the insurance companies and some of them actually pay for them. They claim to be custom made, yet the turn around time is far too fast for anything to be custom made, and they all look the same size and shape wise. Now to purchase these outright without insurance coverage they are anything from $200 to around $600. The same type products are made available at regular stores for around $20. So the question yet again becomes, would your doctor do it if insurance didn’t pay for it? The answer yet again is a big resounding NO!
The only true benefit to the doctor by offering you these type products are purely profit driven. I’ve seen offices thrive off of this stuff and I’ve seen offices die off of this stuff. Sometimes the eye on the bottom line takes the eye off of the true matter at hand, is it ethical and medically necessary.
The work that I do is covered by insurance companies. If it wasn’t, I would still be offering it to people. It’s what I went to school for, it’s what I believe in. I don’t offer any of that other stuff. It isn’t worth it to me to cross that barrier of distrust, and putting all of your faith in a product that in reality doesn’t do much of anything.
People depend on their doctors. They put faith in them to do them a proper service, when in reality a lot of these big practices are run by the bottom line and nothing else. When the bottom line drives the medical practice over patient care and quality of care then something is missing. The doctor falls into a rut and starts to repeat treatment and therapies and nothing changes.
Doctors are afraid of what the future holds, unfortunately they are doing nothing to help themselves with it. They would just as soon sit back and blame everything under the sun when the truth is its their own fault.
Be careful out there. Just because somebody seems like they are out for your best interest doesn’t necessarily mean they are. Thanks for reading my rant.
As always, find us online at smithchirowell.com