Executive Vice President's Report

I shared some time with a friend of mine the other day, who I will call Roger Dodger for the sake of this discussion.

Roger works for a firm providing public relations/image building services to professionals and companies _ both profit and not-for-profit. His company recently faced a 32% increase in their heath benefits cost, so they elected to change to a different managed care plan. It was a plan that Roger and the other employees seemed comfortable with, based on their very limited experience.

Roger had to change his primary care physician because his previous one was not in the new plan. He commented that this was not what he would have preferred, but understood that this is what is expected to happen these days.

Roger picked out a new primary care physician and went for his first visit. He liked the doctor, the doctor's staff, and the relative ease of working with the new managed care company compared to the previous one. Roger felt the exam he received was very comprehensive with the doctor taking the necessary time to answer all of his questions and establish the proper doctor/patient relationship.

Based on the exam, Roger was informed that he needed to get some lab work done (standard stuff). He was also told that he needed to get a chest x-ray, which Roger felt was very appropriate because of problems he had been experiencing in his left chest. Roger was told that he would have to get the lab work done at the XYZ laboratory, the lab used by his new managed care plan. Of course, fate would have it that the "damn lab was way the hell across town in the Riverside area". He was told that the chest x-ray could be done at the new facility by the Winn Dixie, which was not that far out of his way.

Roger asked the doctor why he could not draw the blood and send it to the lab as well as doing the chest x-ray. He told Roger that the managed care plan no longer paid him to do the lab service nor for doing the x-ray. The doctor was doing both until recently when his accountant informed him that he was losing money, to the point of having to cut back on needed staff or services if he intended to continue providing this non-reimbursed service to his patients. Reluctantly, the doctor just had to give in to the financial reality. Roger understood this basic principle of business because he could not provide professional services that where not reimbursed if he wanted to remain in business.

Roger went to the new facility and presented the paperwork for the chest x-ray. Of course, he did not have an appointment and after waiting for two and one half-hours finally had the x-ray. Roger is a very easy going type of person and he simply reported that he did not like it but he needed the x-ray. Roger jumped in his car, took the forty-minute drive to Riverside, and had the lab work completed.

Roger looked down at his lunch for a moment and than asked me the following questions; "Phil, how many people in this country have to take four hours out of their day to travel, sit, and wait to get lab work and simple x-rays done that could have been done in the doctor's office in just minutes? How much productive time does the country's businesses and our overall economy lose because of this?" Being the businessman that he is, Roger suggested that those who determine managed care plan reimbursement policies need to realize that the time and convenience of those who are paying the bill is far more important in the long run than the cost it would be to pay physicians to provide these services in their offices. I told Roger I would pass on his concern.

cc: Roger Dodger

August, 1998/ Jacksonville Medicine

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