There is no such thing as a free lunch.  I remember being told that as a young man but didn’t immediately understand exactly what that meant.  It was lunch. Someone else seemingly paid for it. It seemed like a free lunch to me. But as with most people, I eventually learned.

Now let’s warp forward in time to practicing medicine in the 21st century. Let’s talk about insurance companies, Medicare, Medicaid and other third party payers and why I don’t take their money. I practice medicine using the Direct Primary Care model (my patients pay a monthly membership fee and nothing else) for a reason–actually, several reasons.

As with most physicians, I enjoy taking care of people.  It was why I felt called into the profession.  I don’t enjoy paperwork or jumping through hoops.  I don’t enjoy someone else questioning my medical acumen–especially high school graduates. I don’t enjoy bean counters prioritizing my patients’ needs.  I don’t like completing checklists that are only used to prove self-worth.

And, when I charge $150 I don’t want to get paid $78.95. My mechanic doesn’t have to beg me to get paid and I refuse to beg anyone else.  I earned my medical degree and the right to practice medicine through eleven years of hard work and hundreds of thousands of dollars. I will work for those who respect that effort and not for those who don’t.

My dictations now take about a minute and a half each.  I ask no meaningful use questions. I don’t take unnecessary vital signs.  I’m home by 5 and my blood pressure 120/80.

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