Staying Independent...Together

Print Message

   RE: going direct pay - I think
 From: Elizabeth Bird
 To: Member Forum
 Posted: 02-27-2018 16:43
 Message: I am about to start a solo peds practice and this discussion is a little disheartening... Any IMP peds out there that are making a go of it either DPC or insurance based?

Elizabeth Bird, MD
Chester CT
Original Message:
Sent: 02-21-2018 20:52
From: Kris Oaks
Subject: going direct pay - I think

I felt the same way, I also felt I had done everything I could at the state level to try to make them see... In the my case I thought this, if I went direct pay and lost a bunch of patients I couldn't go back and sell my practice, if I sold my practice and hated it and then decided to switch to direct pay, I still could. At any rate, while it is hard to have partners and have to have consensus on everything, I work 4 days a week (about 9-10 hours) and find it much less annoying. My patients definitely miss the lack of barriers they  had in my IMP style practice. I have to say though that while I definitely went through a period of grieving, it is all just fine now.

Kris Oaks
Kristin L. Oaks D.O. Inc.
Worthington OH

Original Message:
Sent: 02-13-2018 22:32
From: Lynn Ho
Subject: going direct pay - I think

So, I think Jean will be the last original IMP standing.

At the end of this year, I plan on severing my insurance contracts and going direct.
I am tired of working 65-75 hour weeks with fully half of my time spent on the demands of insurances - documentation, billing, coding, referrals, prior authorizations, and "quality ( read - checking boxes and pasting text blocks)"
Although in my IMP practice as it stands now,  I could continue to work and earn enough to live well ( about $120-140K per year), I asked myself: why am I working this hard to make insurance companies richer?
After Jan 1 of this year, the 2 biggest insurers in the state began to require 100% specialist website referrals for their respective managed medicare and -caid products, and  I saw my admin work spike another 2-3 hours per week: I also saw the writing on the wall. This incessant grinding down of the primary care work force cannot end well for us (the grindees).
For the past 3-4 years, I worked within the state's quality organizations and the health insurance commissioner's office to try to change the flawed quality measurement system towards more sensible, less burdensome quality measures based on HowsYourHealth, but at our last meeting 2 weeks ago, I realized the obvious truth:  that these bureaucrats really have no intention of changing the rules for small practices to make "quality" work less burdensome. Another pipe dream, up in smoke.
These two realizations coming together have finally cracked my rose colored primary care lenses. This crazy health care wealth extraction system is not going to change, not one iota, until it implodes.

The direct practice upstairs is doing quite well, due to the scarcity of quality primary care in RI.
I'm going to charge the old IMP standard of $1/day for no holds barred primary care ( way less than the going rate of the folks upstairs, who are 25- 50- 75-100 $ per month, depending on age).  I expect I will keep around 1/4- 1/3 of my 750 patients ( we will see! )  so I will get to breathe.  Perhaps I will travel around the country a  little and visit you guys ! For every 100 paying patients, I will see 15 medicaid or medicare patients that don't have the resources to pay me ( I have the list percolating now). Going to use HintHealth for collecting money; possibly may moonlight a little at the Navy base or the University Health center if needed.

Hurrah ! I 'm embarking on another IMP adventure !


Lynn Ho

Copyright 2016 Ideal Medical Practices. All rights reserved.