Thoughts for the New Year 2007

Well, it is almost the end of January. This was a strange winter. Not too cold so far, and some unseasonably warm weather. Because of increased demand, we have added Tuesday mornings to our Scotch Plains schedule.

A big concern of mine this year is the way insurance companies have abused our patients and are not giving us what we have paid for. Most of us have been continually subjected to higher co payments which is blurring the line between weather to go in or out of network. The truth is, out of network doctors are out of network because the insurance companies are paying them less and less, while charging us more and more. In our case, we are no longer in United Healthcare. There were a number of reasons this happened, but we are finding out that with the higher co payments, the paperwork our patients were required to fill out and the nasty things they were doing to us, and to our patients and to the relationships we have with those patients, out of network was better for everyone. The benefits are as follows: The paperwork has gone away. That is correct, no precert forms anymore. With the loss of participation will be the loss of wondering if they misinformed us about precert, as they did last year and then withheld our reimbursements. Although we in good faith tried to straighten it out and get paid after providing proof, this was ignored and more United Healthcare excuses were given. It turns out many medical doctors felt the same way and more are opting out daily.

Many people have been brainwashed to believe that out of network is unaffordable. The reality is that although some doctors price themselves that way, most of us are priced reasonably and have ways for patients to comfortably afford care. Sure, you may not have the 40 dollar co pay which is becoming more common, but for $55, you can get the care you need, without the referral, the hassle, the angst and everyone is happier.

We have tried to stay in network with most plans, for the benefit of our patients. Most doctors would like to. Today, I met with a medical doctor I am friendly with who just terminated Horizon Blue Cross after many years because they continue to pay him less and less, while his overhead continues to escalate. He was quite upset by this especially when he contacted the representative to question her about their policy and the answer was simple, here is how you can resign from the plan. Here is a well respected physician who is caught between whether to do an appropriate EKG on a patient that he is not being paid for anymore. He told me the allergist friend of his has to fight with a clerk to give a non generic medication.

Out of network does not look so bad after his stories. As a doctor, I am torn between great care, a lousy health plan, can I afford to stay in network and trying to stay in network so more people can access us more easily.

What would you do if you were me? For those that know me, I always go the extra mile for my patients. I will do whatever it takes to help them resolve a problem. As a patient, you need to begin to demand your plan becomes accountable and your doctor needs to be treated with respect, and paid at a level that allows him to feed his family as well. Just my thoughts...

The holidays 2006

We just finished the week prior to x-mas and I am looking forward to two four day weekends. As usual, our patient volume changes during the holidays and I took advantage of the extra in office time to totally redo the web site. Check it out at backfixer1.com. I am very proud of this web site, which has been a great resource for both our patients and those who are considering joining our practice family. I am sure I will see the usual emergencies in Scotch Plains, those who waited to the last minute or did not prioritize their bodies needs. For those who have waited to the last minute, I am awaiting your call over the holidays. For those who are more in tune and are taking care of themselves, I will see your next week.

Everyone, have a great holiday and a terrific New Year. Make some resolutions and be true to yourself and follow though.

Yours in health,

Dr C

Advanced Scientific Health Blog

Doctor for New Brunswick Football team

Some of you have heard about my experience last week. If not, let me tell you what happened.

I have been teaching the local High School Athletic Trainers (Atc's) about how they can perform myofascial release and advanced diagnostics of the body, body styles and how foot problems cause many of the issues they see daily.

The trainer of New Brunswick had their best wide receiver out on an injury and had a game in three days that would determine either the end of their season or weather they make it to the championship game. I was asked the following day to look at the injured player, worked on him in the school and he felt improved. The following two days, he was seen in our office and on Saturday, I was told he was running really fast and led his team to victory.

The ATC asked me if I would like to be the on the field doctor for the school for the championship game to be played at Rutgers stadium against Livingston High. I had my portable table on the field, had an on the field pass, was in the locker room with the team and for all intensive purposes, was a member of the team's staff. I even go to attend the halftime locker room pep talk, seen in many movies.

I must tell you this was fun (alittle cold though) and I had the best seats in the house (by the sideline of the field). I was rewarded when the player I helped caught the winning pass and New Brunswick won the game. I saw him proudly dance around the field showing off their schools trophy.

This was one of those times being a doctor was a blast. As many of you know, I regularly donate my time to athletic events. This past year I was fortunate enough to be invited to help at the Pro Bowlers Tour (I worked on a number of bowlers, I later found out are top professionals on the tour), many Track and field events and even a Grapplers Tournament. This football game was the most fun I had at an event all year.