Health Nuts and Bolts

Cited: NWHerald.com

Doctors across the country are struggling with the economy just like everyone else. In McHenry County, private practices are struggling with a weak economy just like others across the country. Some doctors are even having problems with fewer patients coming in and many of those that have insurance. It does not help the government agencies and insurance companies can be slow with their payments and patients have a tendency to put medical bills at the bottom of the pile.

“Doctors are struggling just like everyone else,” said Dr. Gunnar Thors, a surgeon at Midwest Plastic Surgery Specialists in Algonquin.

Physicians might not be joining bread lines, but some practices are foundering. In addition to overhead costs such as leasing office space and paying staff, medical professionals also have to pay for costly malpractice insurance. Add student loans to the mix and it becomes even more difficult. Even during boom times, many doctors have to deal with delays in payments from patients and insurers, Thors said. Poor economic conditions have exacerbated such problems.

“There is always difficulty in collecting medical bills,” he said. “Not so much from patients, but from insurance companies. Increasingly, they are being more reticent in paying what they owe.” Collecting unpaid medical debts isn’t an easy task. And it puts the doctor in the middle of disputes between patients and their insurance companies.

“We try to collect what we can,” Thors said. “However, we’re put in an uncomfortable situation by the insurance companies. All of a sudden we are the bad guys for wanting to get paid.”

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In Illinois, government payments also have been unreliable. Family Medicine Specialists – a general practitioner with 33 employees and offices in Richmond, Waukegan, Wauconda and Antioch – nearly went out of business because the state wasn’t paying its bills promptly. While waiting on more than $300,000 in outstanding payments from the Illinois Department of Healthcare and Family Services last November, several employees, including physicians, had to go without paychecks.

When medical bills are not paid, “the losers are the doctors,” Thors said. General practitioners have been especially hard hit by what Joseph Fojtik called “a very broken and dysfunctional system.” Fojtik, general internist at Mercy Clinic in Cary, spends much of his time outside the clinic researching and learning about medical policy in America. He said insurance companies have lowered the amount they reimburse doctors for performing many medical procedures. At the same time, malpractice costs have skyrocketed, he said.

Things have gotten so bad that Fojtik wasn’t surprised by a recent survey he saw on the American College of Physicians Web site that showed 2 percent of freshman medical students wanted to go into general internal practice. The rest want to become specialists.

The average overhead costs for an office visit is about $40 for each patient, Fojtik said, pointing out that public aid such as Medicaid would only reimburse doctors about $25 for each visit. That means some doctors are losing money each time they see a public aid patient, Fojtik said.

It is difficult to determine how much business doctors have lost and how much uncollected debts have increased. Several doctors interviewed for this article declined to give specific information regarding their business finances.

Pediatric Associates, which has offices in Crystal Lake and Barrington, tries to help its patients pay bills via payment plans and other options, Dr. Johnathan Kaufman said.

“With the economy, we are understanding and we take a proactive approach,” he said.

That often means working with insurance companies and making sure that patients are pre-qualified before their visit. Kaufman said he also tries to avoid going to collections, which can damage a person’s credit.

“We don’t want to go to collections; it’s not good for anyone,” he said.

Kaufman described pediatric care as a “volume business” with an emphasis on quality care. He said it has become more difficult for many families to afford vaccines and routine check-ups, which are not always covered by insurance. Some private practices, like other small businesses, cannot stay in business without prompt payments.

“We’re a shoe-string operation,” Thors said. “And these are hard times.”

Thors stated that he would continue to help women with breast cancer to get needed breast reconstructive surgery despite any difficulties he may be having. “We’re willing to write that off as a service to the community,” he said. “Many of these women have been through so much. It’s sad and it’s scary, so we do what we can to help.”

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My Take: Well, maybe if doctors did not buy brand name office furniture for their offices, they would have more money. Have you seen some of the furniture a doctor has in his/her office? Leather bound chairs, mahogany desks, fancy statuettes and all those leather bound medical books. Of course, a medical office does need office supplies to carry out the business.

However, the doctor in this article seems like someone who would actually be concerned about their patients. And I know at least one other doctor that is concerned about her patients, my doctor! Today, there are not that many doctors who are actually concerned about their patients’ personal well-being and not just their health. If you can find a doctor like that, do not change to a different doctor!

One thing doctors might consider usually is real estate notes to increase the money they have on hand. If they had some, they could sell cash flow notes to keep their practice or facility afloat. This would help alleviate the problem of waiting for payments from insurance companies or government agencies.

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