I think it’s good practice to sit back and look at oneself from time to time with as much objectivity as is possible. For that reason, I look at different aspects of my practice periodically. A conversation with another OD at a recent conference spurred me to revisit this exercise. I specifically examined my patient database with regard to insurance coverage and found that 63% of my patients have Medicaid as their primary insurance. The topic of conversation with my colleague was reimbursement, and he asked me if I accepted Medicaid. When I replied that I do, he said, “I sure am glad I don’t have to take Medicaid.” True to form, I said tongue in cheek that I was glad he didn’t have to either.
After the brief conversation ended, I had a little chuckle to myself before briefly reflecting on the topic. Then, of course, everything I “should have said” came to the tip of my cerebrum. Frankly, no one has to accept any insurance they do not want to accept. This is a free country, after all. I just happen to be lucky enough to own and steward a 75-year-old practice in which 63% of my patients rely on the state of Georgia for their health insurance coverage. I love my patients—very much—and I love what I do. I fight for fair reimbursement just like everyone else, and I do not own a nonprofit business. Am I going to knock someone for not accepting Medicaid? Of course not! Am I going to write an editorial in defense of accepting it after being backhandedly insulted by a tone-deaf remark? Of course!
My residency was in ocular disease, and unfortunately the presence and rate of disease and socioeconomic status are related. Therefore, it works out that I have the opportunity to treat more disease in my patient base than in other patient bases out there. Simply put, in the area in which I practice, it makes sense for me to accept the insurance that I accept in order to practice the way I practice. Nothing is cookie cutter, and I speak only for myself. My situation just seems to work for me—nicely.
No, I do not accept all insurances and vision benefits. In fact, I recently parted ways with one vision benefit provider a few months ago, but that is a separate editorial all together—one which I will likely not be writing. Do I have a great business mind? Not really. Do I enjoy helping people? Of course. We all do. Do I feel the need to apologize for accepting an insurance provider that someone else is “glad” they don’t “have to take”? Not one bit. Am I getting overly defensive on behalf of myself and my patients and probably just need to let it go and wrap up this editorial? Likely so.