Insurance Contracts that Respect the Patient – Physician Relationship?

Friend of IP4PI Charles “Chip” Smutny, DO writes in:

Does anyone think about or have we even tried to come up with our own physician based contract proposal to insurers that could be a way of negotiating our independence as an alternative to their railroading contracts? Since we know that DPC works, cost less and provides better care more efficiently and that insurance will morph to continue to keep its revenue stream, perhaps we should offer up a contract of our own.

Since we don’t like their offer should we have a counter proposal that requests what we want in a legal document that can be validated and support legal recourse in “a partners agreement” instead of the current “employee-employer contract” and that the insurers must be accountable to in court to this new contract?

Simply stated it might read something like this (with 11 pages of legalese from our lawyers that structures the responsibilities and supports the clarity of the following):

  • patients come first
  • physicians have a right to receive pay for services rendered.
  • insurers pay patients according to their contracts, not physicians
  • patients pay physicians directly
  • patients have the right to decide what they will accept as personal risk in their health and in their financial circumstances.
  • insurers may not interfere in any way with the decision making of the patient in concert with the physician.
  • insurers may not set pricing restrictions on physicians. They may however set limitations in their service contract with the patient on what they will cover in their contract.
  • physicians have the privilege and the right to support their patients in their efforts to obtain quality healthcare delivery and insurance coverage
  • physicians have the right to personal privacy and protect patient privacy by only allowing data stripped of unique identifiers to be collected and stored centrally.   Centralized charting must not contain any unique identifiers other than the physicians delivery of care office information.

Please add on or discuss as you see fit!

This discussion might lead to some sort of standardized counter offer to insurers since so many physicians are afraid to leave that system which has steadily moved toward indentured servitude.

Without the Patient-Physician Relationship there is NO Quality Care

Open letter to patients, physicians and lawmakers from Sharon S. Jellinek  M.D.,

This is the first letter I have ever written to a political figure and I pray that someone on your staff will bring this letter to your attention.

I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care…the physician-patient relationship. Without this, there is no quality of care no matter what you do.  Physician patient relationships require time with the patient. Most of my diagnosis is derived from my patient-parent interview and a “hands on exam” of the child. You cannot possibly read a cookbook of medical questions and treatments and have the same result. The current insurance treadmill model of primary care makes this impossible. There is a hemorrhaging exodus of well-trained physicians unwilling to jeopardize this patient relationship. Continue reading