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In the typical primary care medical practice the physician contracts with one or more
insurance companies. The insurance company and the contracting physician negotiate
set rates for each type of visit, diagnostic test and medical procedure. This guarantees
the insurance company a cap on costs and allows the physician access to the insurance
company's patients. However, insurance reimbursement rates leave little or no room for
a profit. If the primary care physician is to keep afloat they must have a high turnover of
patients. This usually entails strategies like double-booking time slots in the schedule,
and limiting patient visits to 15 minutes or less. Further, the schedule is booked weeks
in advance causing patients to face long delays in getting appointments. Physicians
don't like it. Patients don't like it. The quality of care sometimes suffers, and nobody is
happy.

The solution is to avoid these inefficient contracts. This has two effects. The first is that
the physician sets the price for each service and is paid directly by the patient. If the
prices are too high or too low, the business is not viable. The market guides the price,
not some third party insurance company whose primary obligation is to the bottom line,
not the patient. Secondly, the physician can dramatically cut overhead costs by
eliminating the need to staff and equip a billing and collections department. With
reduced overhead, the physician can spend more time with each patient for a
reasonable price. This is not a new idea. In fact, this is how medical practices
functioned prior to the HMO revolution in the mid 1980's. It does not mean that the
patient is necessarily responsible for the entire bill. Depending on the patient's
insurance coverage, the patient can submit the amount paid for reimbursement from
the insurance company. If the patient has an HMO or Medicare, the patient may not get
reimbursed. If a patient has insurance, blood tests, x-rays, and hospitalizations will
likely be covered. We recommend checking with your insurance to verify coverage
issues and reimbursement procedures.