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It's Time for Patients to Become Responsible Healthcare Consumers


From paying our practice's no-show fee to requiring a referral, patients get angry at policies we make them well aware of. It's time for some responsibility.

I had someone ask recently whether we charge patients for not showing up for their appointments. We do have a “no-show” policy and, compared to other practices, our fee is pretty low. And, unfortunately, patients often slip through the cracks. The purpose of the no-show fee is not to make money, it is to serve as a deterrent. Most of the time, patients are angry about receiving a no-show bill. Yes, that’s right. After they have wasted our time and deprived another patient of a slot, they are angry.

Why should I be surprised? These are the same people who would be angry when they are told they need a referral. It is clearly stated in our policies (as is the no-show rule) that it is the patient’s responsibility to know their insurance and to know if they need a referral or not.

They are also the same patients who get angry after receiving a bill because they haven’t met their deductible. Or that they have to pay a $50 copay every time they come.

Now most physicians probably don’t get to find out which patients these are, because it is handled either by the billing manager or the office manager, and the physician only gets to hear about it if the patient complains directly to them. I ,on the other hand, get the inside scoop every day. I come home from a day at the office and am greeted with, “we need to talk about one of your angry patients,” from my husband, who is also my practice's biller. Great.

Now, mind you, they are the same ones who don’t understand why they need to be seen periodically before they get meds refilled. The same ones who say, "I don’t have time to see a hundred doctors."

They are also the ones who don’t want to take “no” for an answer to their (in my opinion) unreasonable requests. “Can you add a leptin level onto my lab request?” “Can you write a letter to the electric company saying I need air conditioning?” “Can you write a letter to get me out of work/jury duty/my DUI?” Oh yes, I really got that last request. “Can you write a prescription that says I check my blood sugars 4 times a day even though I only check once because it’s cheaper?”

I had posted recently about how physicians and physicians’ offices seem to be held responsible for failures in the system, but how about patients being responsible? I’m not even talking now about being responsible for their health, just being responsible as a consumer.

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