Our doctor is dropping all insurance and Medicare participation but isn’t telling his patients until they show up at his office, or if they just happen to read his web site. Should we do anything about it?
My partner had a doctor’s appointment Thursday, and the doctor refused to see him. This is the primary care physician in Houston that we both have seen since early 2003.
I'll call him Dr. Voldemort; he’s a prominent local physician whose practice combines internal medicine, primary care, and HIV-related care. He has advertised for many years in the Houston Voice and OutSmart (gay rags) and has a number of patients with AIDS/HIV who are dependent wholly or partially on government assistance with their health care.
My partner has been HIV-positive since the early 1980s; he does not have full-blown AIDS. He has, for unrelated reasons, been on Social Security Disability with Medicare and Medicaid since the early 1990s. His medical problems and issues are legion. Since we moved to Galveston in 2002, he started seeking care locally at the UT-Medical Branch, then switched to private doctors in Houston seeking more proactive and less bureaucratic care.
We both have been seeing Dr. Voldemort since 2003. I am HIV-negative and basically healthy, fwiw, although I have occasional health-care needs. Voldemort and his staff have been generally helpful and have referred us to a number of incredible and gracious specialists in Houston who have provided some of the best care my partner has received in years.
Anyhow, it seems that during the summer of this year, Dr, Voldemort decided that he will be dropping all insurance, PPO, and Medicare participation. Instead, he is choosing to require patients to pay in full for services at the time of the office visit, and pay according to his fee schedule.
Although those changes go into effect October 1, his office staff would have required my partner to make a payment for the visit because the doctor has already stopped participating in Medicaid, which is his supplemental coverage for his Medicare. My partner could not pay the money, so he was turned away. Starting October 1, patients will have to pay up front and then submit claims to their own insurance. Under Federal rules, the ones who have Medicare will not be able to submit their claims to be paid, since Dr. Voldemort no longer participates in Medicare and does not accept the Medicare reimbursement level.
Although the doctor has a right to run his business this way, essentially turning it into a medical boutique, what we really can't understand is why he didn't notify his existing patients. When my partner was there Thursday, they were pretty rude about it. The doctor would not speak with him at all, and the office manager said that it was too expensive to notify their patients that the changes were happening. "This isn't a free clinic! We are salaried here!" What a snob.
So, my partner left. He was so upset that he got lost driving home. It's at least a two and a half hour round trip from here to that part of Houston, gone to waste, that could have been avoided. When he got home, I checked the doctor's web site and found a notice from July about these changes. They had weeks to let us know. At a minimum, his receptionist could have told my partner this was going on when he made the appointment. yes, I know I'm ranting...
The bottom line from all of this is that my partner will be able to continue with his existing specialists, just as before. One of them, the HIV specialist, will probably be able to pick up his primary care, although we need to check that out. We're still just stunned to see a business decision in a so-called "caring profession" communicated and handled in such a callous way. I can't imagine what the rest of Voldemort's Medicare patients will do, especially if they come in for an appointment after October 1 and suddenly discover that they won't be cared for.
So if you’ve made it this far, here’s the question: Should I do anything about this? Call the Houston Chronicle? The Houston Voice? Marvin Zindler? Anybody? I keep thinking of other people who will show up at Voldemort’s office seeking care, especially after October 1. They will be turned away because they can’t or won’t pay for the office visit. Especially the ones on Medicare, who are probably on a fixed income… I’m hoping that the ones who may have an HMO have received a notice from the HMO that their doctor will be “out of network” on that date. As a Voldemort patient, I have a PPO, and I have not received anything like that.
It troubles me. Do I have a moral obligation to tell someone? If so, who do I tell? Or is it o.k. to tell myself that with my partner’s poor health and many issues in our lives, that it is better to keep the obligation to ourselves to preserve our privacy? I especially do not want to identify my partner to others in the medical community as a potentially “difficult patient” who would make waves or get them “in trouble.” His medical needs are so pressing that maintaining the best relationship with his care providers is essential.
I want to make it clear that I think the doctor has a right to conduct his business as he sees best and make changes to his insurance affiliations or have none at all, if he wants. According to his web site, he believes that the U.S. medical system in broken, and he is opting out because he wants to provide a higher standard of care for his patients. That’s fine, if that’s what he wants to do, even if the only patients he will eventually care for live in River Oaks or West.U and drive Mercedes and Jaguars… My bone of contention is that he is not telling his patients in advance of doing so, and many will be left in the lurch.
posted by Robert Angelo to health & fitness (16 comments total)
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posted by Robert Angelo at 3:12 PM on September 16, 2006