A Letter to Healthcare Providers from a Consumer

Now that the rules of healthcare delivery have changed so dramatically, we need to be clear about our new relationship. If you thought haggling with insurance companies was rough, just wait until you hear my expectations.

10 comments on "A Letter to Healthcare Providers from a Consumer"
Jane Orient (1/20/2014 at 1:01 PM)

YOu are welcome as a patient if you value my services. I expect honesty and transparency from patients also.
Stephen E. Galya (1/17/2014 at 8:17 PM)

I was quite disappointed by Mr. Commins statement about physician assistants, and not physician's assistant as he put it. This gentleman obviously has no idea of the training PA's go though, or what they are capable of doing. I have been a PA for 21 years, and currently work in family practice, and manage patients with hypertension, diabetes, lipid disorders, and other chronic conditions. We as PA's work hard, and research has shown that patients are at times more satisfied with our care than MD's. A truly hurtful and disappointing statement. This man should have done some research.
G Constantinopolos, MD, MBA (1/14/2014 at 10:12 PM)

Transparency and communication is a must indeed. However we must all speak the same language. Too many people in this country consider healthcare a social "good" which they are entitled to as it is the right to walk in a house workship and pray. But the providers see it as a market " good" for which a financial transaction is due. Physicians are not a commodity as the insurance plans seem to believe. The time is coming when you will have to pay a good premium to select a physician who is an expert in his field. As a consumer you know you get what you pay for. But I would also agree that the unchallenged super inflated hospital charges should come to an end. It is now clear that hospitals are big profitable businesses with little if any concern to their captive customer base. They can not operate within the non profit arena trying to compete with the private practitioners who have supportersd them through the good and bad times Hospitals and their highly paid administrators offer no care, they just facilitate, it is the physicians who do that !
Bruce L (1/13/2014 at 2:11 PM)

The patient has always been the consumer of medical care, just as a child or a pet is the consumer of pediatric or veterinary services. But as in the two examples above, the patient has not been the CUSTOMER for a long time. The customer has been the employer, or the health plan or the government. Unfortunately, in those two examples, the customer has a benevolent interest in the care that is given. The health plan or government have no such interest in the consumers for which they are paying, so they are only worried about the costs. Employers tend to have a little more at stake in the care. So if the price you pay is capped by contract or fiat, then you still haven't made it to full customer status. If the price is limited then the service will be limited as well.
Casey B (1/10/2014 at 11:19 AM)

I am disheartened about Mr. Commins' joust at Physician Assistants. Numerous studies confirm that patient satisfaction with PAs is on par with that of physicians.
Janice Oliveri (1/10/2014 at 10:21 AM)

Hello John, Although I agree with most of your article, I don't think you are addressing the realities of practicing medicine. As an internist, practicing for almost 20 years, I would appreciate your thoughts on these issues: Most businesses do not give care away for free. ALthough hospitals vary in their costs and some are outlandish, I agree, the 20 dollar aspirin is paying for the patients who have no insurance or no way of paying. Do you think we should deny treatment to those without the means to pay? Honda is not giving cars away, the last I checked. ALso the expensive tests are often due to the costs of the machines to do the tests. Do you think we should regulate how much GE, etc is allowed to charge for the equipment? DO you think patients should give up their right to sue if the risk of finding something on an MRI or other test is low, but real? AS for access to docs, very few are going into the primary care specialties because derm and radiology pay more. It tooks us years to replace a doc so even though we have extended hours it is tougher to do because of simple supply and demand. 11 years to train a doc and 6 to get an MBA. Medicine is not a business in the traditional way you are thinking and until the playing field for regulations, malpractice and free care are addressed I think you may have a hard time finding a doc!
Tosk59 (1/9/2014 at 4:42 PM)

Generally good stuff. However, this statement is rather silly: "What it costs you to keep your doors open and your lights on is not my concern" Eh? Is this not what all consumers end up paying for regardless of the industry they are interacting with? I'd very much like this "consumer" to please let me know the names of the businesses that price their products without covering these costs, I would like to shop from them!
Robert Trinka (1/8/2014 at 3:29 PM)

Very good article and a great list of consumer "wants". Consider, however, that many, if not most, ACA compliant programs, like those offered on the HIXs, have very limited/narrow provider networks. In some cases you won't have a choice of providers since there may be only a single in-network provider. So my response to you the consumer from me the ObamaCare era Provider is: "OK, fine, go somewhere else and pay the increased out of network rates, coinsurance, deductibles, etc. "But, I suspect you will want to come back to us and simply do what you're told, as always!" "Also, if you are Medicare, I don't get paid very much, so please do go somewhere else." "And, if you are on Medicaid, I won't treat you so that ends the negotiation." Employers may still have some leverage, but I don't see how consumers' leverage is any better than before, probably worse. Your scenario would be nice, but first we need true provider competition - which means we get rid of ObamaCare and go to a private, market based system.
Betsy (1/8/2014 at 3:27 PM)

My comment: Anyone who knows me knows I hate being referred to as a "consumer." In thirty years, I have never felt any similarity between being a patient and being a shopper or "consumer," but I have certainly felt the need to be patient. Healthcare is unquestionably a seller's market in the US at best, and many times it compares to robbery: your money or your life. It is too easy to blame "consumers" for the health care problems in this country when you think of people as marketing targets and ignore the fact that they are the weak, the suffering, and frequently the desperate.
@DonaldStumpp (1/8/2014 at 2:10 PM)

Two new conversations in healthcare - Patient: "Doctor, why do I need this, how will it help, and how much does it cost?" Doctor: "Patient, before I do this, how will you pay for it, and are you prepared to pay today because I wont bill you?"


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