Saturday, January 22, 2011

"Do you take my Insurance?" The Truth About Insurance

If you are a doctor of any kind you have heard this question. If you are not a doctor but have been to one, you have probably asked this question. But what does it really mean? What does the answer that follows it mean? These days the meaning is a lot different than it was about 20 years ago.

Take the average insurance plan that comes through my office on a daily basis. Patients either have high copays of over thirty dollars, or they have a super high deductible (usually between $1,500 and $3,000) before the insurance company will pick up any of the expense. Doctors must be making millions of dollars with figures like this right?! Not even close.

Let's not forget, insurance companies are a business. In the state of New York, insurance "covers" chiropractic care. Usually they set a cap for reimbursement for a patient visit. Speaking candidly that fee max averages at about $35. That's thirty five dollars, when you spell it out. If your copay is $30, the insurance company will send a check for the balance of $5. That's five dollars. Good thing you are covered huh? If you didn't spend $400 dollars or more in many cases a month your insurance company wouldn't pick up those extra $5 associated with each visit. You would have to get treatments at a rate of 80 times a month to reach your $400 monthly premium (which is on the low end by the way). This example of course is in the absence of deductibles.

Deductibles are the patient's responsibility (your responsibility) for out of pocket expense BEFORE the insurance company will start absorbing payment to your treating doctor. Let's use the average deductible of $2,000 for this example. If you have a $400 premium with a $2000 deductible, you are accepting that you will need almost $7000 worth of health care each year! Don't believe it? Add it up. $400 x 12 months = $4800. A $2000 deductible that you have to pay before the insurance company will take responsibility for chipping in plus the set $4800 is $6800 per year. Do you need that much health care? Without insurance a physical with your primary care can cost about $200. Expensive services like getting eye glasses made can cost as much as $500. An endoscopy and colonoscopy would run you about $800 to $1000. Of course there are situations like surgery where one visit would run your bill over the $10,000 mark, but if that is your concern you should be speaking with your insurance broker about catastrophic care and relying on yourself to pay other health care fees as they will be significantly less than your insurance costs annually in many cases.

This is not meant to be a sob story. I want you to understand how the insurance industry works. Patients struggle to find quality doctors who take their insurance. Doctors struggle to give you the care you deserve because they need patient volume to survive. It's a viscious cycle.

So what are the alternatives?

If you carry health insurance, of course it makes sense to ask if a doctor takes it before deciding whether to use the doctor's services or not. The doctor's answer however should not be the deciding factor in your decision. Consider your insurance first. Do you have a high deductible? Do you have a high copay? If you do it is likely that you will essentially be paying cash for your services regardless of the doctor you go to. When I have a patient come in with a $40 copay we know very well that the insurance company isnt sending us a penny to supplement the payment. The copay is really the entire pay. The insurance books and the insurance provider websites just become referral sources for doctors in many cases to recruit new cash patients. Are you a cash patient? If you have a high deductible or a high copay you probably are.

So the answer is simple. Find the best doctor and allow them to give you the best care available. A common rebuttle to this suggestion is "but Dr. Sean, your fees are a a little higher than my copay and I can't afford that." It's a fair statement. However, it is important to know what your payment is getting you. If one doctor is more expensive than another but he gets you well in half the time, over the course of treatment the fees might actually be less.

Health care has become a confusing game of finance. Fortunately common sense still prevails. Find the best doctor, and let them get you well regardless of what insurance plans they take or don't.

Tuesday, January 11, 2011

Is Chiropractic what you think it is?

I've been around chiropractic my entire life, and it wasn't until about a month ago that I really understood what exactly it is. With my father having started his practice 30 years ago (3 years before I was born), you would think that by now I would have a pretty firm grasp, but it's just not the case. Don't get me wrong, my patients were improving and my quality of care was high, it was the word "chiropractic" that I couldn't wrap my brain around. With so many doctors practicing so differently, what does it really mean? What does a chiropractor do?

I know what I do and I know what my father does, and I know what my friends from chiropractic school do. So I thought it was important to find out what people from different schools, who were taught different philosophies do. A friend of mine went to Life Chiropractic College West in California where the philosophy is heavily based on the nervous system controlling the entire body and mind. They are known for reducing "subluxation" through use of chiropractic adjustments and thus improving overall bodily function. My friend's patients get well.

I went to a school that is more medically modeled. Physiology and bio mechanics were important aspects of our education. We are commonly called "medipractors" by other chiropractors who do not learn from the same curriculum. I address joint dysfunction, soft tissue dysfunction, and nerve dysfunction to come up with the most appropriate and effective treatment for a given symptom set. Sometimes that treatment is a simple adjustment, sometimes it is more involved and can include soft tissue manipulation adjustments and exercises. it really depends on the patient presentation.

So, if my friend and I practice so differently, how could we possibly call ourselves the same thing? My friend called me last week and we discussed at length (2 hours) what we were doing to build our reputations, our practices, and our skill sets. We discussed what chiropractic is, and we came to a very clear conclusion. Chiropractic is the drug free administration of care at the best interests of the patient. It's very simple. While we both do it very differently, we give the patient exactly what they came in for; a side effect free, efficient, resolution to his or her ailment. Both my friend and I are after the same thing, what we believe is best for the patient. We both refer for nutritional consults with nutritionists or dieticians we trust, we both refer to medical doctors when patient complaints turn out to be outside of our scope, and we both get results.

When I spend time out in the public meeting perspective new patients, after listening to one of my talks, people typically come up with many questions about themselves. I answer the best I can and then let them know that if they come into the office I can be much more thorough with my answers. That's usually when they ask what type of doctor I am. When I tell people "I'm a chiropractor", they decide immediately if it's a chiropractor that they need to help them. My question to you is this: I've been around Chiropractic Care my entire life, and until about a month ago I couldn't identify what it really is. Are these people making decisions from an educated place? The answer is probably not. Their personal experiences in all of their years on earth led them to the moment that they make the decision to come in or not. The only thing that can alter the decision making process is experience and knowledge. People don't even know what we do. Now, you have a better idea. But in case you forgot I'll repeat myself.

Chiropractors provide patients with efficient, drug free, holistic, resolutions to their complaints. When done right it's a beautiful thing, we don't change symptoms, we change lives.

Before choosing a chiropractor you shouuld call the office, ask questions, make sure you are going to a doctor you believe can help you. Believing you are going to improve is half the battle.

Questions or comments? Let me know. Comment below.

Friday, January 7, 2011

How is that New Year's Resolution Going?

Do you find yourself struggling to accomplish your new year's resolutions? Don't worry, you're not alone, and there is a good reason for it.

Every year people like yourself make resolutions, promises to yourself that something about your life is going to change for the better in the new year. The problem is that you are not always being realistic about your goals. The first obstacle that many people face is lack of a time frame, and this is paramount.

January first. That's the first day of the "New and improved you." Right? You were supposed to join the gym, start eating right, get more sleep, make more money, have a better relationship with your spouse and with your kids. You were supposed to reduce your stress. Well, if you are anything like me, and most other people, just looking at a l ist like that is stressful and thus counter productive. It's easier to hide that list in a desk drawer than it is to actually put it into action. So despite our best intentions, that's exactly what many of us do. The fact is, this list is simply too much to accomplish in one day! Just because you didn't lose a pound on New Year's Day doesn't mean weight loss can't be accomplished in the new year. It's not you that is flawed - it's your approach. Let's try a new one.

It's good to have a long list of life changing goals, but they need to be measureable, and attainable. For example, don't say "I wasnt to get in better shape this year." You have to define what "better shape" means to you. WHat does that look like? How will you feel? How many inches do you want to lose? Do you want to be able to run a mile? Maybe you just want to lose 10 pounds and keep it off this ti me. Whatever they are, your goals have to be specific, measureable, and achievable. Start small, if you haven't run around the block in a few years, running a marathon can still be a goal, but you will need to set smaller, more achievable goals first. For example, try aiming to run around the block without getting winded, and progress from there once that goal is achieved.

Once you have made a list of real, attainable, measurable goals, it is important to write them down and store them somewhere important, or somewhere you will see them often. Maybe with your jewelry, after all, they are more important than your bracelet aren't they? Writing things down signifies commitment. It's easy to change your goals when things get difficult if you haven't written them down. Putting goals to paper will help keep you in check. Once you have your list written, you should prioritize it. Put the easiest goals first and the most difficult goals last. Accomplishing your easier goals will help you build self confidence and will make those large difficult goals seem much more attainable. This list that you are writing, while specific, also needs to be fluid. Simply put, if you achieve your goals, it doesn't mean you stop progressing. Continue to rewrite your list of goals with new ones as you accomplish the old ones. Save your old lists as reminders of where you came from.

You can accomplish all of your goals, it just takes the right approach. You would probably benefit from telling a friend your goals. When someone else knows, they will commonly ask you how you are doing with your progress, this acts as great external motivation to keep moving forward. Sometimes you will even find that your friend has the same goals you do. Your book club buddy could turn into your jogging buddy. Believe me you are less likely to miss that run if your friend already woke up early and is counting on you to be there.

There is no bad time to start changing your life for the better. It doesn't have to be a Monday, and you're not to late if you didn't start on the first of the year. Make a decision and start working towards your goals. Marathons are run one step at a time. Good luck to you on a happy, successful, and healthy new year.

There is no bad time to start changing your life for the better. It doesn't have to be a MOnday or the first of the year. Make a decision and start working towards your goals. Marathons are run one step at a time. Good luck to you on a happy, successful, and healthy new year.