My Doctor Won’t Accept My Insurance Anymore by Jan Shoenberger, MD
Tuesday, February 9, 2010 
Jan Shoenberger, MDWelcome to 2010 at the Los Angeles County General Hospital. During my first 3 shifts of 2010 at the County hospital, we had no less than 10 patients present to the ER with a chief complaint of “my doctor won’t accept my insurance anymore”. We get referrals from community doctors all the time, but these “referrals” were different. As of January 1, 2010, these doctors had elected not to continue caring for patients with various types of insurance. Whether it was a low-budget HMO type coverage, the state-sponsored Medi-Cal program, or some other type of minimum coverage, the doctors in these cases decided it wasn’t worth it to continue to care for patients with this type of coverage. So, they sent their beloved patients a letter explaining the severing of their relationship or refuse to make them an appointment over the phone and refer them to the County ER. At our ER, they get to wait hours to be seen in order to be given a referral to the appropriate clinic.
These patients that are falling through the cracks have coverage. They are not counted in the masses of uninsured patients. Yes, they are underinsured, but is that their fault? They have done what they were supposed to do – they filled out the forms, paid a small premium, waited in the lines, even found a primary care doctor they faithfully went to – and now they are dumped into the vortex of the county health care system. This is because their doctor has a choice. Their doctors chose to refuse to be underpaid for the care of these patients and they are trying to start 2010 off on a better financial foot.
Many of these patients who I saw had chronic medical conditions. One was a renal transplant patient whose doctor dumped her as of January 1st and she had not taken her immunosuppressant meds for 3 days because her doctor wouldn’t see her to renew her prescriptions. Her transplant was on the line because her doctor changed the rules and didn’t arrange for any transfer of care for this transplant patient. Wouldn’t even renew her prescriptions!
Here’s my idea. Why do these doctors have a choice in the matter? How about ALL doctors who hold a medical license in the state of California be required to have a certain percentage of the care they provide be Medi-Cal patients? Like 10%? 15%? Even a measly 5%? They can still have their cash cow patients, their PPO covered patients, etc. but they have to have a certain percentage of their time dedicated to caring for underinsured patients in order to maintain their license in California. In the ER we are mandated to provide coverage to “all comers”, why don’t other specialties have a similar requirement?
Reader Comments (3)
ABSOLUTELY! This is a great idea. . . unfortunately, I'm sure it will never come to fruition.
How about, instead of requiring physicians to accept a certain percentage of underinsured patients, how about we require insurers to pay a reasonable rate for our services. Or even better, how about if physicians are allowed to bill patients directly and then they can apply to their insurers for reimbursement.
It's certainly easy to see the author works for salary. Put Dr. Shoenberger in a overhead-intensive business environment and tell her she "must" see a certain percentage of her patients at a loss, THEN have her re-write the article.
There is no such thing as "cash cow" patients anymore.