Wednesday, May 02, 2007

Similarities between physicians and body shops

A few months ago, a sign post unexpectadedly came out of nowhere and dented the entire passenger side of my honda. I won't say who was driving. In any case, my wife and I did not want to put the repair through insurance, fearing, as most of us do, our insurance company. So I took the car to a few body shops for estimates. Most were in the 3-4 grand range since this was cash pay, and thus full price. In addition, these body shops did not contract with our auto-insurance carrier. In the end, fearing run-away costs, I contacted our insurance company and put the claim through the insurance. I had the car fixed for a fraction of the self-pay estimates (total cost, including deductible) and it was fixed just fine. So that got me thinking about body shops and doctors and the similarities between the 2 occupations. Here are some:

  • Most people cannot afford auto body work as a cash pay. Most people can't afford health care as a cash pay.

  • Most people use body shops that contract with their insurance company to save money. Most people choose doctors in their plan, to save money.

  • Some people have collision insurance that allows them to use any body shop, but the deductibles can vary. Some patients have "out-of-network" benefits, though the co-pays can vary.

  • Mechanics in the "out-of-network" shops promised me that they would accept my deductible and not balance bill me for any "extra" charges not covered by the insurance. My hand surgeon did this exact same thing. He promised not to balance bill me for the difference between his fee and the 30% of "usual and customary."

  • Auto body shops don't waive deductibles. Doctors don't (or should not) wave co-pays.

  • Auto body shops wait for the reimbursement checks. So do we.

  • The car insurance company publishes a list of sanctioned auto body shops in my vicinity. The health insurance companies do this as well.

  • The car insurance company pays the auto body shop a lower rate in exchange for the promise of higher volume and thus more money. Same in medicine.

  • Auto body shops need to fix lots of cars in a short time period to make money. Doctors need to see lots of patients in a short time period to make money.

  • Auto body shops use expensive tools to help them align parts and ensure that the repair is adequate. Doctors use expensive tools to diagnose and treat disease.

  • Some people are not happy with the result of the auto repair. Some patients are not happy with their outcomes either.

  • Auto body shops have manuals with standardized parts and labor reimbursement rates. Doctors have CPT and ICD-9 books.

  • Contracted auto body shops can't balance bill you. In-network doctors can't balance-bill either.

  • Auto body shops that cater to Porches and Ferraris can charge a lot more than typical auto body shops. Plastic surgeons in Beverly Hills can charge a lot more than a general urologist can in Suffolk County NY.

So there they are. It sucks too admit it, but it is true. We are really just glorified auto body shops with $200,000 in education debt and $30,000 plus per year in malpractice insurance premiums. Don't get me wrong. I love what I do and I treat every patient to my utmost ability and effort. I just understand my place in the grand scheme of things.

Sorry if I offended and I hope you enjoyed the post.

The IU.