Recently I've been putting my HRA dollars to use by going through the normal chain of routine check-ups. As everyone is well aware, sometimes visiting the doctor's office is less than pleasant. For some reason, medical professionals don't seem to think of what they do as a business and as a result, we are not treated as customers.
I'm not writing this post to complain about that, because that's been done to death (although it would feel good to vent a little). Instead, I want to ask a serious question:
Is there actually a reason for medical practices to be run the way they are?
What I mean is, this is a free market and it seems like if doctors are actually as bad at running a business as most of us believe they are, someone would come along and take over the market. If I heard about a doctors office in town that actually honored reservations, I'd go there without a second thought. Even better, what if they didn't make you sit in a tiny room for 30 minutes just so you can get five minutes of face time with the doc?
Similarly, couldn't doctors make more money by running a more efficient business? A doctor's office has to pay for their real estate, equipment and staff so if most patients are just sitting in a private room twiddling their thumbs, that means that there are unnecessary costs. By figuring out a way to actually honor appointment times and cut out the 30 minutes of waiting from each visit, it seems like a doctor could seriously increase the number of patients they see while decreasing the overhead of running the business.
So I'm asking a serious question to doctors and nurses out there. Is there something at work here that I'm not aware of? Is there a reason why it's difficult to honor appointments? Why do I always have to wait 15-30 minutes between seeing the nurse and seeing the doctor? I have to believe that there's some way to justify all this waste, but I just can't come up with any reasonable explanations on my own.
Somehow we've developed a culture in America where everyone thinks that it's taboo to pay directly for certain things. Healthcare in particular has this strange fog of mystery surrounding it which causes people completely dissassociate the service with the price.
I have a friend that was complaining about how it had been four years since she last went to her dentist. I asked her why and she said that she didn't have insurance. It was as if she was resigned to the fact that there's no way to see a dentist unless you have insurance to cover the visit.
I pointed out that dental visits aren't generally covered by health insurance and dental insurance itself is generally pretty worthless. Most Americans pay for dental visits with their own hard-earned money.
Her response: "Oh..."
This isn't a problem with one person not knowing something that should be common knowledge. We as a nation have this bizarre idea that we can't pay for things. It doesn't matter how much money we have, we can't go to the doctor unless insurance covers it.
Part of this confusion is caused by how secretive doctors are with prices. If you could go online and see the price for an annual physical, you'd view it just like anything else that you buy. However, because no one really knows how much things cost, many people don't believe that they have the ability to pay themselves.
We've got all kinds of posts about the problems this causes, but for now, let's all remember that your doctor's office is just like any other business: they provide you with something and they get paid. There isn't any black magic going on here.
