Why don’t you accept insurance?

Before I went to medical school and I would go see a doctor, I always thought that the insurance company was on my side. I would receive an explanation of benefits that showed that my insurance company had gone to bat for me and dramatically decreased the fee that the doctor was “allowed” to charge me. It made me feel as though they were protecting me from the doctor who is out to “overcharge” me.

Having been a foot doctor and surgeon in private practice who did at one time accept insurance, I realized that the insurance company is only interested in protecting their profits. In fact, the CEO of United Insurance company once stated that the insurance company would never attempt to keep doctors on the insurance plans at the expense of their profits.

Some insurance companies contracted rates that they offer as pay to doctors are so low that it is simply impossible to provide good patient care.

I once received a package via FedEx in my office from an insurance company. The delivery person said that I needed to sign for the package in order to receive it. When I opened the package there was a contract modification that dramatically reduced the rate the insurance companies said they would pay me for taking care of their members. Unbelievably, at the end of his contract was a paragraph that stated that by signing for receipt of the package constituted agreement to all of the conditions contained within the contract inside the package. It is absolutely ludicrous to think I would have agreed to rates without ever even opening a package. But these are the games that the insurance companies play.

The insurance company industry representatives have stated that any doctor should be able to see a patient in five to seven minutes. If you’ve ever been to the doctor, this is ridiculous. Now having said that, I have worked in clinics where I saw 60 people a day. I also believe that the patients did not receive quality care.

What I believe is quality care is providing evidence-based medicine as well as thorough explanations and patient education. All of this is necessary in order for a patient to participate in their own care. Providing a prescription for an order for an MRI or just an recommending that someone return in a few months is not really providing care.

Anyone with diabetes or any complicated medical condition deserves to have explanations. They also deserve to have their questions answered. And they certainly deserve more than five to seven minutes.

I have had multiple other doctors contact me and ask me for surgical second opinion on the patient. I have had many cases where these patients clearly needed a procedure that the insurance companies said they would not pay for. Those doctors then asked me what the second-best procedure was. I would supply them with my opinion. In most cases these other doctors would say, will you please come scrub in with me on the procedure that is covered by the insurance company.

In this scenario, my answer was always the same… absolutely not! , I would tell them that if you want to allow an insurance company to tell you to do the wrong procedure just because it cost them less money than you can do it yourself, and I will not participate.

At the end of 2008, I decided that under no circumstances would I allow an insurance company to tell me how long I can spend with the patient. Under no circumstances can insurance company tell me that the cheaper procedure is necessarily better. At least not better for the patient. So I opted out of Medicare and decided to no longer accept any insurance whatsoever.

High quality medical care is expensive. It doesn’t have to be prohibitively expensive, but it does have to provide the best outcome for the patient. Making decisions based only on price is a mistake for the patient. It is also a mistake to the doctor in the long run. A string of bad outcomes (whether because the wrong procedure or wrong medication was chosen) would certainly not be good for any doctors reputation. But when doctors choose to follow the guidelines of the insurance companies rather than their own medical decision-making, this is exactly what happens.

But this is not a problem for me, because I don’t accept insurance. Patient care comes first and cost is second.




Dr. Christopher Segler is an award winning diabetic foot specialist. Although he has performed plenty of diabetic foot amputations, he firmly believes that diabetic foot amputations result from a continually worsening health care system that the force patients to live with the lowest cost treatments and deprive them of patient education. He does not accept insurance assignments of that he has the time necessary in order to provide the education for his patients that can prevent diabetic amputations. You can learn more by requesting your FREE report “No Leg Left To Stand On: The Secrets Insurance Companies Don’t Want You To Know About Diabetic Foot Amputation” at http://www.ineedmyfeet.com.