Having insurance doesn’t mean healthcare is free

having health insurance doesnt mean free healthcareOne of my pet peeves is simply the complex healthcare system that I knowingly work in. Hypocritical, yes. What is unfortunate and frustrating is that the majority of our patients don’t really understand how the system works, and assume that doctors are making a killing off of the healthcare system. Doctors, too, are mostly unaware of how the healthcare system works.  If doctors knew exactly how the system worked and learned to save their earnings, then there wouldn’t be as much of a need for physician financial education. Case in point:


The bill that your insurance company mails you does not reflect your doctor’s income.

This is the number one deceit. Your patient sees you in the office, and the insurance company sends her a statement of performed procedures and charges made. The charges on the bill absolutely do NOT indicate the amount that your doctor receives from the insurance company. In fact, I have had instances where the insurance company actually denied my claims, sent my patient a billing statement of charges, and have a patient comment on “how much I made on her 25 minute patient visit”. Disgusting. I didn’t even get paid for taking care of a patient, and my patient thinks I got paid a ton for her visit. So much for altruism.


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The copay also does not reflect how much a doctor is paid.

Another one of my patients commented that her copay went up to $50 per visit from last year, and that she hopes that “I am getting a good raise” now that I’ve raised my copayment charges. Score one for the insurance carriers. They’ve successfully convinced the public that higher copays equate to more money to the doctors.


Having health insurance doesn’t mean that you never have to pay for care.

A common patient complaint I receive is that they are upset that the insurance company did not pay for all of the care. That is the definition of a deductible! One of my colleagues complained to me that one of his patients basically received a free knee replacement because he refused to pay for any of the deductible for the surgery, and was not willing to pay for any of the postoperative medications. My colleague still had to see the patient for all of the postoperative care. It was okay, because the patient was sporting a new Apple Watch and iPad Pro in the waiting room.

You can still win the lifestyle and financial game even in medicine.

Despite the skepticism and cynicism with how broken our healthcare system is, we can still win the game. Remember, we entered this profession to care for patients. No matter how misguided our patients are with how the healthcare system works, we can still deliver great care to them and earn a decent living out of it. Here’s how to do it:

  1. Win the lifestyle game. Find a way to carve out a four-day workweek. Maximize your productivity while you are at the hospital, and minimize the amount of work that you take home. Know your value, and grow your value. Prevent your obsolescence to avoid getting fired.
  2. Win the financial game. Save more than you earn. Hustle to increase your income. Learn to become a successful doctor. Generate your income stream and work hard.

What other strategies have your implemented to win the financial and lifestyle game?

(Photo courtesy of Ubi Desperare Nescio)

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