Blog | Monday, July 30, 2018

Do insurance companies care about patients or profits?

Readers know of my hostility toward overdiagnosis and overtreatment. I maintain that there is probably twice enough money as needed to reform the health care system if unnecessary medical care could be eliminated. (Yes, I am including colonoscopies in this category!) The challenge, of course, is that one person's unnecessary medical care is another person's income.

One institution that is routinely demonized are medical insurance companies. They are described as Houses of Greed who put profits ahead of patients by design. Every physician who is breathing can relate tales of woe describing frustrating obstacles that insurance companies place before us and our patients. When one of my patients receives a ‘denial of service’ notification, I am always prepared to discuss the patient's case with a physician at the insurance company, as this provides an opportunity for me to explain the nuances of the case to a colleague.

Take the following quiz now.

Which of the following tasks is most difficult to accomplish?
• Getting an upgrade from coach into first class of the plane for free.
• Calling the IRS to get some personalized advice from a living, breathing human being.
• Understanding your medical bill.
• Solving your internet malfunction by consulting the company's “FAQ” page.
• Reaching the medical director of a medical insurance company.

I know that these companies have medical personnel on the payroll, but finding them requires assistance from intelligence professionals. They likely arrive at work in disguise and work in a secluded office behind a door labeled “Maintenance.” Years ago, while I didn't actually connect with a live physician, I was afforded the opportunity to leave my phone number on a voice mail. If the physician did deign to return my call, it was never at a time that I was available to converse. Since I do procedures every day, round at the hospital and have a few offices, the probability of the physician reaching me with a single call was equal to the chance that you will be served Surf ‘N’ Turf on your next airline flight.

Yeah, I know I sound frustrated, and writing this blog post has released some of the pressure. In fairness, there are many times that the medical community and the public take advantage of the insurance companies. I will share some thoughts on this in an upcoming post.

If you need to call a doctor, take my advice. Don't call the one who works for your insurance company. Try something when the odds will be more in your favor. Play the lottery.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.