Cash Only -- another in a trend?

[Guest guest]

Story on a cash only practice.

The responders again miss the point -- they point out that nobody can afford healthcare visits of a $100 when they forget they are paying $200-500/month to the insurance company.

Why not pay the doctor directly?

Anyway, interesting info.

Locke, MD

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Radio Gift: Dr. Boots Tries A No-Insurance Model

by Rose

Listen Now [5 min 1 sec] add to playlist

Rose/NPR

Some of Dr. Crowley's patients call her Boots because she wears Doc s to work.

Day to Day, December 23, 2008 · We only have radio to give you this holiday season. With that in mind, Kathleen Tacelosky asked us to produce a story on her sister-in-law — a doctor in New Jersey who doesn't accept health insurance from her clients.

http://www.npr.org/blogs/daydreaming/2008/12/radio_gift_dr_boots.html

Radio Gift: Dr. Boots

Rose

--Steve Proffitt

This season we asked listeners what they wanted to hear for the holidays, and we responded to their requests with a few "radio gifts."

This one goes out to listener Kathleen Tacelosky.

She wrote us this letter:

Crowley, M.D. is a family practice/primary care physician in New Jersey who is intensely dedicated to her craft and her patients. But healthcare has become an industry in our country, and it is out of whack. She was spending an insane amount of time negotiating with the insurance companies trying to get approvals and trying to get paid.

Instead of letting her frustration get her down, she has come up with a gutsy, creative solution: As of October 1, she dropped all insurance and Medicare and went all cash. She had a meeting with her patients about it. She's lost some patients, of course, and she's gained new ones. She's keeping a blog about it where she shares what led up to this, her fears, her occasional feelings of guilt, what others are saying to her etc.

She's been writing about her experiences on a blog.

Note that her blog name is "bootscrowley." Some of her patients call her Boots because she wears Doc s to work. She's unconventional, determined and has a lot of pluck! I think she'll inspire your listeners as she has me and others who know her.

We sent reporter Rose to visit Dr. Boots, and his story is today's radio gift. Happy holidays to all who wrote us, and thanks for letting us give you a little radio.

Avruskin (nevadaPT) wrote:

As a physical therapist, I know several practitioners who have gone this cash-based-business route. I had a very small cash-based practice myself for a short while, when I lived in a very rural area. And some of the medical professionals I choose for my own healthcare do not take insurance. So I can see the situation from both the receiver and giver viewpoints.One of the first dilemmas that arise in a no-insurance office is patient "sticker shock" versus covering overhead expenses and being paid for your time and expertise. In my current practice, many patients regard even a $25 copay as prohibitively expensive, so asking $100, like Dr. Crowley does...may indeed cause customer loss.Hopefully, a solution may be found in the middle. Charging less than $100, or offering shorter visit times for a reduced fee, may allow greater accessibility. I would have been very interested to hear how Dr. Crowley decided on her visit fee amount, what the considerations were and how it was calculated. And, although a doctor can determine the fee he/she will accept for their services, lab tests and diagnostic procedures can be enormously costly; I am interested as to how these could be handled in a no-insurance situation.

Wednesday, December 24, 2008 3:53:54 PM

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(themarycarter) wrote:

Dr. Crowley joins many other doctors who have decided to go it without the insurance companies. The tone of this program was very upbeat and positive, but the ultimate result of patients' having to pay for services out of pocket is that only people with money will be able to afford medical care. Is this right? Is this okay? Is this fair? What about those of us who cannot afford to pay out of pocket for our medical care? Are we just supposed to go away and be sick without any medical care?

Tuesday, December 23, 2008 9:13:50 PM

http://www.njafp.org/njafp_custom/practice.aspPractice: Crowley Name: Crowley Email: bootscrowley@... Job Title: Physician Address: 307 Stone Harbor Boulevard Cape May Courthouse, NJ 08210 County: Cape May Business Phone: Business Fax: Home Phone: