I thought I had surely mentioned to you that a visit to the doctor, for me, is torture (and not the good kind). In fact, I have a whole tag devoted to it. I can trace this back to childhood pediatrician Dr. Downey although we can scatter blame around liberally if you want. There’s plenty.

You can imagine my delight (which, in this case, is equal parts relief and terror that she might retire despite being my age) in finding a doctor who not only sees the whole family, but is nice, approachable, doesn’t wear doctory clothes, and often gets us in on the day we call. She manages the family’s health without being condescending or judgmental, things you would hope are a given in one’s doctor but, in my experience, are not. We treasure her. And she took our insurance.


Used to.

Past tense.

A month ago we got a pleasant but frank letter about a change in her solo practice. She is moving to a new model of care that more closely mirrors the golden age of house-calls except she can’t be paid in chickens or fresh bread. Nope. She can’t be paid in anything except actual money that is not, to be clear, the money already deducted for our health insurance. In exchange for old-timey, part-of-the-family, care, each person pays a monthly fee instead of a copay.

There were tears, my friends.

Without some serious tightening elsewhere, we can’t afford to pay monthly above and beyond our insurance. Legislation is pending to allow payments like these via a flexible spending plan but pending is not actual. My bank account doesn’t actually get the ideas of pending, patience, or eventually. My credit card does but he’s a wily bastard and not to be trusted.

And so here we are. We’ve a month left to decide whether we’re staying or going and while all signs point to staying, we haven’t yet figured out how to manage the costs. I think I’m a bit paralyzed about it all, especially about the idea of finding a new doctor and starting over. My medical history is a smorgasbord of awesome (if you consider awesome to be both baffling and predictably catastrophic).

This is the second doctor I’ve had stop taking insurance. Are lots of other doctors doing this? Is this some sort of medical industry trend? Is Aetna (our only choice) so horribly awful (we don’t think so) that providers run for the hills? And the million dollar question, how worth it is it to pay, essentially, twice for a really great doctor?

The decision is mostly made but, jesus, I wish it weren’t so complicated.



22 Responses

  1. Yikes, that’s an interesting predicament you are in. I had no idea that was even something doctors did. Wow.

    • I had no idea either! I was wondering if it’s a trend or whether it’s just a “solo doctor, small practice” practicality/necessity. At any rate, it mostly begs the question of whether the care will be (can be!) better. It’s already pretty stellar to begin with!

      On Mon, Jul 21, 2014 at 8:06 AM, Counting Chickens wrote:


  2. My spouse was seeing a doctor she liked a few years ago who started doing this. Took her a while to find a doctor she liked again after that. I had never heard of it, but I guess it is a thing.

    • Gah. I was hoping it wasn’t a thing! I’m glad she eventually found someone else. We’re on the hunt for a new gyno (we accept no more shaming of body size and/or other health issues) and I can’t imagine it will be easy!

  3. That sucks, a good doctor is worth so much. Could you stay with cash-money doctor and send the rest of the family to someone who takes insurance (I wouldn’t know if this is happening in my area because I can’t bring myself to find a new doc).

    • We definitely considered this. It may come down to our laziness though – the convenience of going to the doctor who will treat all of us at the same time or at least knows the family so well she can treat in a way that makes sense for everyone can’t be denied. Regardless, that’s a suggestion that isn’t totally off the table yet – glad to hear some confirmation that it might be a sane thing to do.

      • This was going to be my question/suggestion as well. Sucks.

        When I changed jobs I could have switched to a cheaper insurance plan but I would have had to switch doctors. I love my doctor, though, so I pay extra. Worth it, but I recognize I’m still covered by insurance so this comparison only goes so far. Good luck to you.

      • It’s amazing how important a good doctor is. I feel lucky that we can afford to even consider it!

        On Mon, Jul 21, 2014 at 8:07 PM, Counting Chickens wrote:


  4. Dealing with insurance companies is a headache for doctors and there are some who choose not to deal with it. I’ve read about this new ‘trend’ of doctors doing this monthly fee – it’s great if you go to the doctor on a regular basis I suppose…
    I can assure you, Anthem has hands down the worst plan. We were on that for a few years when Pat switched jobs.

    • I think Anthem in this area is so bad that my doctor sent an additional letter noting that even on a “pay monthly” plan, many insurance companies would cover parts of the visit if we submitted the paperwork – Anthem was the sole holdout…

      On Mon, Jul 21, 2014 at 9:54 AM, Counting Chickens wrote:


      • I think it depends on the plan – we had excellent coverage from them for years when Pat worked for a much larger employer. When he changed jobs, our plan changed significantly. Everything we paid, from the monthly premium to our co-pays doubled. Still Anthem, just a different plan through a much smaller employer.

  5. Wow, I’ve never heard of that. But I totally get not wanting to give up a good doctor when you’ve found one. I’ve yet to find one. :/ I should check out your doctors tag – I bet there’s some overlap with my own experiences.

    • Not unless you want to descend into angst… That said, I love to commiserate with others and their dreadful doctor stories. Maybe we need a whole “my doctor is/was an asshole” forum!

  6. I am so sorry. What a nightmare. I can answer a few of those questions for you, though. I work in the insurance industry, so I do have a bit of inside knowledge. Yes, lots of other doctors are doing this. It’s their trendy way of coping with insurance company insanity. My mom’s doctor charges a hefty annual fee for “concierge service” that includes his 24/7 cell phone number. Also, Aetna does have a horrible, awful, terrible reputation in the industry. Food for thought: it may not be FSA eligible, but I vaguely recall my mom mentioning that the fee is tax deductible since it is paid to a doctor. I’m not positive, but it’s possibly worth exploring. I know that doesn’t help with the outlay of cash, but it’s something.

  7. We see our family doctor who we LOVE who doesn’t take our insurance. Yes, it sucks, but it’s worth it because he is so amazing. Good luck with your decision making!

  8. I wasn’t aware of this trend either, and you’d think I would be, because I work in health care. It’s also upsetting because the largest employer in the area (UVA Health System) has Aetna for its employees.

    • And with no other options, if I remember from enrollment. I’m hoping legislation passes to allow an FSA to help cover it!

      On Mon, Jul 21, 2014 at 8:43 PM, Counting Chickens wrote:


  9. Oof. I am sorry. I would probably switch doctors, because I am really cheap. Lots of doctors rs in nyc don’t take insurance, because there Are so many people here who can afford to just pay. (some have this concierge model, but some just charge cash.) I see the appeal, but I feel indignant about it all the same.

    • Wow – I’m alarmed to hear it happens as often as it does in a much bigger city (much.) I guess it’ll at least be interesting to watch it evolve!

      On Tue, Jul 22, 2014 at 10:44 AM, Counting Chickens wrote:


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