Is Money Affecting Your Doctor's Care? How to Choose the Right Doctor for You

money and doctor's care

Does money affect your doctor's care? If your long-time doctor is retiring or you're moving to another state, here are some tips to help you find a good doctor.

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When you go to your doctor, you'll always see welcoming smiles from him and the nurses. But do their courteous and caring mannerisms reflect the level of care you're really getting? Or are these just standard operating procedures they go through robotically because they're part of their practice's mandatory operation?

Sadly, this might be the case for at least some practices. Did you know that in Twin Cities, almost 5,000 nurses are on strike because they're unhappy with their compensation? These same nurses were probably smiling happily and welcoming patients the day before their strike began. They probably didn't let on to what they were feeling inside, but it probably affected the level of care they gave.

It's a reality for physician care as well. Don't believe the stereotype that all doctors are making huge six-figure salaries. It's true that many doctors, like neurosurgeons, orthopedic surgeons, cardiologists, dermatologists, and plastic surgeons, make over $300,000. But did you know only 47 percent of nephrologists are satisfied with their income?

According to McGill University medical school professor Dr. Richard Cruess, doctors “are less altruistic, and more financially driven now....” It only makes sense – doctors and nurses are people too, with financial needs and responsibilities. You probably believe that all doctors are selfless and always giving -- heroically putting their patients' health first above other priorities. But not many people can live in such an ideal charitable vacuum. Doctors are people, not comicbook superheroes. They have the same problems as you. Certainly most doctors are selfless, but not 100 percent of the time. Being a medical doctor is a profession, and not religious volunteer work. When gas prices, taxes, and rent rise, they need to make more money too. They may even have children and families to support. What happens when you have auto loans to pay or when you take out a mortgage? You try to make more money to compensate – and like you, doctors do the same thing.

In fact, medical professor and emergency medicine physician Dr. Marissa Hendrickson says that “'financial realities do at times have an effect on physicians' behavior....'” Differing physician behavior can be readily seen with the two popular physician practice payment schemes: fee-for-service and pay-for-performance.

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Fee-for-service is when doctors are paid by how many patients they see. Even if individual physicians would rather see less patients so they can provide better care, the insurance companies and practice group they belong to might want to maximize their business's revenue by constantly trying to increase the number of patients a doctor sees per hour. This results in less time and care given to each individual patient.

Pay-for-performance is when doctors are paid by how much care they provide. With this payment scheme, it doesn't matter how many patients a doctor sees. An individual doctor providing a set number of quantified care to one patient could be compensated the same as a doctor who provides the same amount of care but spread over multiple patients. But Dr. Hendrickson notes that this payment scheme also allows for abuse by insurance companies and management by requiring doctors to order unnecessary tests and procedures for patients, which makes your doctor's visits more costly.

How to Maximize Your Care

If you're suddenly afraid you're not getting quality care – don't be! All physicians are bound by state and federal laws to provide a minimum amount of competent, quality care. Even if insurance companies are making healthcare providers see many patients a day to maximize their profits, these doctors and nurses are still required to make sure you're getting adequate medical care when you go to see them.

What you should look for in a doctor is one who accommodates your personalized individual needs. Some people like being warmed up into talking, needing to be buttered up by caring questions in order to open up. Others don't like doctors who prod or pry. Doctors are required to ask a certain set of questions depending on what you tell them, but anything beyond that is their personal style of doctor-patient interaction. Vanderbilt University Medical Center advises you to choose a doctor who listens to you carefully, asks the amount of questions you like, takes the time to explain everything so you can understand, and respects you.

According to Dr. Joseph M. Haack, a Board Examiner of the American Orthodontic Society, when choosing a new doctor, you should do your research. Ask trusted coworkers, friends, and family for possible candidates. Then check their practice history online for any malpractice records or disciplinary actions by the board. If they're being recommended by other patients and if they have a stellar practice record, chances are they'll give you quality care.

Doctors are people too, with bills to pay. It's not far-fetched that they've got some financial incentives that affect how they provide care. The best kind of doctor for you is one who you're happy and comfortable with.

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