In the past two years I’ve personally employed the services of architects, structural engineers, attorneys, auto mechanics, accountants, and other highly trained professionals. All of whom have skills and training that enabled me to do things I cannot do. NONE of these professionals had any problem asking me to pay them. In fact, I didn’t get to enjoy the outcome of their work UNTIL I had paid them.
Why are doctors so different?
I can suggest some reasons based on what I see happening in healthcare and in the wider culture. I can also throw in the talks I have with many doctors and administrators. I have some loose ideas based on those conversations. But those conversations always tend to leave me a little fuzzy. What they say about their motivations, and what they do as a result seems to diverge. But let me take a swing at it. I will start from a broad cultural perspective.
I read a lot of news. The political landscape and its battling ideologies cannot be escaped. I’ve noticed that on one side of the political isle there’s a determined push toward a single-payer health system in America. They push forward a half step, the opposition pushes back. But it seems the voices for socialized medicine (at least in the publications I read) have grown louder and more common.
As I understand it, this push is based on an ideology that every citizen has a ‘right’ to good health, or at least to good healthcare.This seems to be the message the single-payer side repeats without relenting. If we could just have government control, we can make it fair, and give everyone the care they need. I’m not going to argue here if that’s a power play by one side, a reasonable expectation of a wealthy society, or a monumental pipe dream.
I’m just going to say that the message is getting through and a larger and larger portion of our population is buying into it. The bottom line result for you?
A significant number of your patients expect to be treated
without regard to their financial ability or intention to pay you.
I suspect you completely disagree with their position. Patients should expect to pay. But the truth is, your industry, and perhaps even your practice, is reinforcing this expectation every day. Every patient that walks into your office, receives treatment, and walks out without paying for that treatment has his or her expectations reinforced.
To compound the problem. We treat patients without giving them a clue as to what the cost will be. Think about that. Which of the professionals I mentioned in the first paragraph would you consider hiring with NO IDEA what the cost might be? And do you expect any of them would allow you to pay whenever you are ready, with no penalty?
This is where my conversations with doctors and administrators get fuzzy. I talk to them about the ideas I just discussed in the last five paragraphs. Almost to a person, they acknowledge this is happening and that a solution needs to be found. And almost to a person, they don’t take action in their practice. It’s frustrating!
The statistics are abysmal for the number of practices that automatically check eligibility, create a patient estimate, collect a co-pay, and put a card-on-file or create an automated payment plan to ensure payment of any remaining balance. Not to mention those who have simplified their invoices so lay-people can understand what they’ve been billed for.
Practices may have one or two of these tools in place but very few have all of them. If they do have the tools, they most likely don’t have the policies and enforcements in place to make them worthwhile. Nor have they informed the patients of the benefits and bonuses available to them with the use of these tools.
The truth is, any practice that will implement these tools and enforce the use of them will change the expectations of their patients. Then, as practice after practice implements these tools, the expectation starts changing for a community, then for a state, and then for a country. But left unchecked and unchallenged the expectations for free medicine will only grow.
And even as I write this I understand the fears of the doctor. Doctors fear they’ll lose patients, they’ll be forced into conversations about money, they’ll have to become a ‘retail’ shop with no flexibility to make medical decisions, or some patient will complain to a regulatory agency. All of which will make their lives miserable. I get it.
But I also know that companies who provide these tools for practices have done a great deal of work to learn how to use them in a patient friendly way. We know how to talk to patients. We know how to help them understand the process. We know how to set their expectations without upsetting them. And we can teach you and your staff.
If asking to be paid is painful for you and your practice staff, or if your patients aren’t responding to the way you are asking, it’s time to get help. Reach out to us or to your local consultant and start learning how to take the pain out of asking for payment. We would love to help you!