The Customer is Always Right, Right?

If you apply the old saying, “The customer is always right” to health care, who’s the customer?

The knee-jerk response to this question is “the patient.” But there’s more than just a buyer and a seller in the business of healthcare.

You see, while the patient is a buyer, to whom are they really buying from? When they’re dependent upon their health insurance card, the seller isn’t their doctor… it’s their insurance provider (IP).

The doctor certainly provides a service, but not just for the patient… it’s also for the patient’s insurance company. The question you have to ask is who are they really aiming to please?

If you still think it’s the patient, think again. Sure, they want their patients to get the desired result, but at the end of the day (or in this case, the end of the month) when it’s time to pay their overhead, mortgage, and BMW payment, the insurance company mails the check, not the patient.

Regardless of how happy you are with your results, if the doctor doesn’t satisfy the insurance company (by way of billing & diagnostic codes), he doesn’t get paid. So… is his focus more on them or you?

Let’s recap. You pay the insurance company… in turn, the insurance company tells you they’ll cover the bills. The insurance company pays the doctor for some of it, and while you may be responsible for paying a portion, it’s tempting for the doctor to be more focused on “what gets me paid?” rather than “what gets them well?”

When you think about it, health insurance companies should be at our beck and call. But instead of “the customer is always right,” to them it’s “the customer is always wrong.” Patients’ requests for more treatment options get denied. Medical practitioners’ requests for higher compensation also get denied.

Instead, all we really get from these companies is big fat one of these.

All the more reason for you to take back control and pay for the services you want out of pocket. It’s a sure-fire way to get the care you need and deserve.

7 Comments

Dennis Kaufman Wednesday at 12:20

I would love to pay for all of my medical services “out of pocket” but the costs would be prohibitive as a recent example I spent 4 days in a cardiac care unit at my local hospital. They found nothing but keep me on an IV because the CATSCAN dye had elevated my creatnine levels so they had to flush the dye out of my system for three days when I should have been discharged after one day.Can you imagine the bill I’m going to receive and without my health insurance I would be bankrupt!

    Dennis, thanks for your comment. Your type of situation is the exact reason people need health insurance — to cover big ticket expenses of that nature.

    What I’m suggesting is that people pay out-of-pocket for the bite-sized expenses like checkups with their MD, dental/chiropractic care, etc, instead of always expecting the insurance carrier to foot the bill.

    Consider this blog post by William Davis, MD (http://bit.ly/c0rwxS) — he highlights a very good point regarding the impact we have on other patients’ healthcare premiums.

Dr. Adam…

This is a really great article today and how you explain the patient, doctor, insurance dynamic kicks butt. This is a great blog and you’re doing it like a Rock Star.

Great article doc. Keep up the awesome work.

This has got to be one of the best and most powerful blog posts you’ve ever written. Great job!

Dr. Adam.

So true! Love this blog post!

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