Your voice: Payers fracturing physician-patient relationship

July 3, 2018
Volume 95, Issue 13

Letters from our readers

Payers fracturing physician-patient relationship

It isn’t so much that patients don’t trust their doctors, but more that the respect for them is diminished. When I was in medical school, I was told that we were not just doctors but scientists who should strive to make healthcare better.
Now we are called providers that follow algorithms and everyone has a doctoral degree. Thus, the term doctor to the patient is not as meaningful as it used to be. Patients also see the money aspect more today. In the past, you paid the doctor either cash or your deductible and that was all. Today the system nickel-and-dimes people with constant copays and extra fees that the doctor has to collect which makes the patient think we only care about the money. Due to reduced reimbursement, patients also see doctors selling them braces, vitamins, stem cells, Botox, and anything else that is cash. That is why the trust is gone.
Patients wonder if they get a good deal for their dollar when they are badgered about money at the front window and then the doctor walks in and abruptly walks out or tries to sell them something not covered by their insurance. The unfortunate flip side of this is that people want medicine to be like the airlines: cheap, on time, and with no errors. I believe that we have gone down a road that has no turns and where it ends is probably not good.

Scott Haufe, MD
Destin, Fla.

When cost trumps care, doctors lose respect

n response to “Waning trust in physicians,” (April 10), the lack of trust in physicians by our patients can be laid squarely at the feet of the health insurance industry. They collect the premiums, decide whether or not to pay for the care decided upon by patient and physician, and then make statements such as “investigational,” “experimental,” or the most oxymoronic, “we are not against the treatment but we will not pay for it.”
As the middleman that muddies the waters and profits the most by doing so, we would see a tremendous improvement in the appropriate care of patients if health insurers were required to pay for all healthcare deemed medically necessary and beneficial to our patients. The level of customer (patient) satisfaction would be unprecedented.
Until this scenario occurs, we will just continue to treat the symptoms of the health insurance “cancer” rather than getting to the root of the problem.

Kevin J. Donnelly, MD
Tampa, Fla.Solo practice ‘in their death throes’


Unlike Keith L. Martin in “No matter the pressure applied, independent physicians will survive” (First Take, April 25), I do not share the optimism of the 80-year-old family doctor mentioned in the article who said that independent physicians will survive.
Perhaps large independent groups of say five or six doctors will survive if they have the help of nurse practitioners and physician assistants and if they use EHRs, and if they have staff that is adept at coding they may just make it.
But not the solo practices. Many are already in their death throes.
Solo practitioners in general practice except in some rural areas will soon become a thing of the past.
Despite the optimism expressed by the veteran solo practitioner (I liked his attitude), the combination of the physical and emotional stress that goes along with seeing patients, complying with insurers’ rules and regulations, and trying to survive financially in solo practice have already begun turning young doctors away from solo practice.

Edward Volpintesta, MD
Bethel, Conn.

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