BELLPATTON, Iowa -- A study recently showed that "nearly one in three doctors reports withholding information from patients about useful medical services that aren't covered by their health insurance companies, and the number may be on the rise."
A report reveals that the study's authors say their work offers the first empirical evidence for what many have long suspected: that coverage limitations imposed by managed care are infiltrating doctor-patient communications.
"I give my patients the whole story," said Dr. Elias Dunsmartinsmith, who is a DO. "I learned my lesson a long time ago when some guy came in with an axe lodged in his arm and, fearing his insurance did not cover axed arms, I said, ‘Don't worry, it'll take care of itself,' and then told him go home and drink plenty of fluids. Three weeks later I felt sorry for the guy and realized I could have done more. These days I spend two hours with each patient, no matter how slight their problem may be, and I give them every option."
But, a doctor who consented to talk to me under the condition of anonymity, which is not a condition covered by any insurance company, said something that confirmed the study's findings. "Look," he said, through a Richard Nixon mask he wore, "I have to make a living here. People think doctors only want money for boats and expensive furniture but we, too, have to feed our children and goats. People without insurance can have us all looking for jobs of lesser quality-like becoming a dentist. I don't give bad advice, mind you. I just don't give all that is available."
One patient, Bea Surregard, told me that her doctor advised she take a trip to Bermuda to cure an unknown malady that caused her to feel as if her spleen were about to explode. "He said to me that all the pain might disappear if I could just spend some time at this lovely beach resort he and his wife went to every other year," she said. "He gave me a brochure and showed me snapshots of him and his wife with a couple they swapped partners with during the vacation. Then he told me he could sell me a video tape of what happened. All because, I now know, my insurance company wouldn't pay for treatments."
The results put light on several years ago, when some managed care companies barred doctors from discussing medical options not covered by the health plan. Public outcry persuaded most companies to dump those rules, known as "gag clauses," and many states banned them from contracts. Now, the public will be more aware that a doctor could be less than open due to their health plan.
"I read this report and went right to my doctor," said patient Urich Vonderslap after he read the report aloud word for word, taking only one breath. "I told him I wanted to know every last option about treating my sickness and demanded that he also document on paper his opinions on world hunger, pollution, abortion and who will win next year's Kentucky Derby."