Frustrated doctors say insurers meddle in patient care

Sep 25 2009

"Have you ever wondered why your doctor has you come back two or three times to complete a check-up instead of wrapping it up in one visit? Doctors candidly admit that it's about money," CNN reports. They say insurers are to blame. Dr. Ted Epperly, president of the American Academy of Family Physicians "explained that if multiple services are administered to a patient on the same day, insurers often won't reimburse doctors for each separate treatment. … Doctors don't think this is fair. While some are eating the cost of additional services rendered to patients, others are having patients come back repeatedly so they can be adequately reimbursed."

"Although the tension between doctors and insurers is decades old, Epperly believes it is reaching a crisis point" and says that "[d]octors are fed up with the administrative hassles and other obstacles to getting reimbursed." Paul Keckley, executive director of Deloitte Center for Health Solutions, explains that the "tests, medications, procedures that doctors prescribe are largely responsible for driving up health care costs." He adds that little of the rising inflation is consumer-driven. Insurers often provide guidelines to doctors on what treatments may be most cost-effective based on evidence-based data. But the struggle between "a physician's clinical judgment and insurers' focus on evidence-based medicine" is a point of contention (Kavilanz, 9/25).

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