Archive for the ‘reimbursements’ Category

Patients Are Crazy

July 13, 2009 8 comments

.. or at least one of the people I follow on Twitter says we patients are crazy.  You can see his post here:


My reply to him was that he shouldn’t be so surprised that a patient wants to review a second opinion.  Let’s look at point of view:

Suppose your car is making a horrible noise.  You take it to the mechanic who tells you your engine needs to be replaced.  Knowing what that will cost, not to mention that fact that it means your car will be out of commission for — oh — three weeks — while the engine is replaced, you take it to a second mechanic.

The second mechanic tells you that you don’t need a new engine.  You really only need to replace the belts.  That will cost you (money, time, grief) only a fraction of what replacing the engine will cost.

Now what? What if Mechanic #1 is right?  But, what if Mechanic #2 is right?  How are you supposed to know?  Do you need a third opinion?

If you trust Mechanic #1 (because, remember, trust and the expectation that he is 100% right 100% of the time are two different things) then it requires a further conversation with Mechanic #1. You need to know why he’s recommending the engine be replaced and why he doesn’t  think simple replacement of the belts is enough. You have additional questions, and you are confident Mechanic #1 can answer them.

And that is what your patients want to know.  They need a way to compare the two opinions they have received.  They need to know how you arrived at your recommendation. If they return to you, they do so because they trust you.  They just need to understand it better.

Put another way — what if it was you or your child? What if you had a difficult decision to make that would affect your child’s health and two people had told you two different things.  How are you supposed to figure out all the important details?

Patients aren’t crazy — they just don’t know the protocol.  They don’t understand reimbursements.  They don’t understand that you can only bill them if they show up in the office for the conversation.  They don’t get that you aren’t interested in donating your time to them.

But if you treat them as if they are crazy, they will never get it.

How to get beyond that hump?  Invite them in to discuss — through a billable appointment.

Your patient needs only a simple explanation.  “Mrs. Jones.  Dr. FirstOpinion would be happy to discuss this with you, but we’ll need to make an appointment to do that. Can you come in Thursday at 2 PM?”  Then, when Mrs. Jones arrives, explain to her that her payer requires an appointment be made to discuss options.  If she is puzzled, explain how reimbursement works.

We patients need all the information we can get.  And we need your respect for our information gathering efforts.  We want to collaborate with you, looking to you as our #1 resource for the information that will help us make difficult medical decisions.

Patients aren’t crazy.  We just need to learn. And we want to learn from people we trust.  Like you.

*Note:  Please see PediatricInc’s response to this post


Learn more about Trisha and her work.

Learn more about Trisha’s book
You Bet Your Life! The 10 Mistakes Every Patient Makes

(How to Fix Them to Get the Healthcare You Deserve)