Letter From a Doctor: Consumer dissatisfaction With U.S. Healthcare System

There isn’t a week that goes by that I don’t hear a complaint from a client about how they had to spend hours waiting to see their doctor, how another clinic charged them a fee they weren’t expecting, or how their insurance company wouldn’t cover any of their expenses. Frankly, people are fed up with the current healthcare system in this country, and healthcare professionals aren’t much happier. Insurance coverage and reimbursement have been reduced to a juvenile game of offer/counter-offer based on complex algorithms and the subjectivity of claims officers. This has lead to a decline in the number of healthcare providers willing – or able – to put up with the status quo. Combine that with an increasing and aging population and you’re left with an inflated patient to practice ratio, increased wait times, and unhappy customers.

To illustrate this dissatisfaction, here is a recent story that a patient told me about his experience with another clinic:

I was referred to an imaging center to get a colonoscopy to see if I had diverticulitis. I contacted the imaging center and scheduled an appointment. I asked them how much the procedure would cost and whether my insurance policy would cover it. The representative at the imaging center told me that I would have to contact my insurance company.

I called my insurance company and they told me that they didn’t have enough information to help and that I would have to call the imaging center back.

I called the imaging center back and the rep I spoke to said that I would have to speak to someone in billing.

I was transferred to billing and they told me they couldn’t get me a price because they needed a CPT code.

I was transferred back to scheduling and I was told that someone would call me back three days before my test to let me know how much it would cost.

I never received a call.

On the day of my procedure, I checked in and was asked to sign a form agreeing that I would be responsible for all fees incurred from my procedure regardless of insurance coverage. I asked again what the cost would be and was told that my insurance company should have told me. I was left with an ultimatum; sign the form and pay an unknown amount of money out of my own pocket or cancel the procedure and jeopardize my health.

This is just one of a number of examples of how healthcare providers have forgotten who their clients are. In any business, common sense dictates that you take care of the people who give you money. Unfortunately, healthcare companies have forgotten that they need to take care of their patients, not the other way around.

There’s an old quip that states, “If you want to be successful, do the opposite of what everyone else is doing.” At Causenta, we strive to do the opposite. Our  clients don’t have to wait for hours to see a doctor. We disclose all fees associated with their treatmentbeforehand. We consult with their insurance provider to get them as much coverage as possible. The healthcare system is a mess, and we continually do our best to make things as painless as possible for our clients, because we’re in the business of taking care of them, not the other way around.