Thursday, December 06, 2007

Damn December

December! Everyone loves it, right. The holidays, parties, joy, peace and love on earth.


The holiday season can be a difficult time for many people. The depressed or lonely are the obvious people that come to mind. But I'm talking about the small business owners. Whether you are in retail, food service, or health care, the holiday season brings many challenges to your business. In retail, for example, experts project poor sales for this year, and owners, managers, and employees of retail chains and mom & pop stores alike may suffer the consequences.

Medicine, contrary to what I was told as a pre-med student, is far from recession proof. In medicine, we suffer right along with everyone else, minus the insurance execs.

I am not going to get into the economics of whether or not we are in a recession. We are, however, in a period of difficult economic times for many people. This economic downturn, in addition to consumer pressures that the holidays bring, mean less money spent on health care. i.e., we, the doctors, suffer.

Let's take the example of a typical patient of mine, a 35 year old man who wants a vasectomy. He works for someone else, most likely a big, faceless corporation or government agency, and his employer pays for his health insurance. His family income is $150,000 per year, which does not go very far in the New York metro area. Like everyone else, his co-pays or deductibles have risen dramatically in recent years. Far from being 5 dollars, now they are in the $35 to $50 range. His children, like my own, have had one cold after the next, after the next, and he has paid several hundred dollars in co-pays for his kids' pediatrician visits. His oldest daughter wants a new dance leotard and a Webkins doll for Christmas and his younger girl wants a Fiona doll and a Bella Dancerella video. Perhaps he and his wife agreed to not spend money on each other, but knowing that this really means "get me something," he buys his wife some inexpensive jewelry and plans to take her out for sushi. On top of all that, the pre-school/day care tuition for his toddler is due by Jan 1, or else, and that ain't cheap.

So how does this affect me? Well, he and his wife have decided that 2 children are enough and that he should have a vasectomy. Most likely, his insurance will cover it. But he still has co-pays. And I don't waive those. I simply cannot do that. Since he has all these other bills to pay, does not relish the idea of paying the 2 or more co-pays required for the vasectomy. In addition, he can't afford to take any time what-so-ever off from work, even though vasectomy patients recover quickly. He thus decides hold off for now on his vasectomy.

Multiply this times 20 vasectomies per month, times God know's how many other elective things that I do in urology, and you can see why December can be a difficult month for a urologist or any other doctor.

But Happy Holidays.

The IU.