Demystifying Medicine

Why Going To The Doctor Sucks

September 26, 2022

Sonia Singh MD
I'm a primary care doctor who is passionate about food, writing and making healthcare less frustrating and more empowering. These are my musings. Thanks for reading!

I’ve met so many people who tell me they’ve literally NEVER had a good experience going to the doctor.

Of course, as a PCP, this makes me sad to hear but it is no surprise. I admit it, seeing us generally sucks.

So WHY is this the case? Are doctors just greedy, socially inept, burned out robots who don’t listen and just push pills?

Here are the real reasons:

1. Insurance Contracts Kill Competition

Doctors have to negotiate contracts with insurance companies in order to be paid by them. If you are a solo doc, you have no leverage compared to a giant group or system so your contract will suck. You will get paid less for the same work.

Since reimbursements have gone down over time, more & more doctors can’t survive independently and feel forced to join bigger systems or networks.

What’s so bad about that, you ask?

2. Doctor’s Have Lost Autonomy

70% of doctors are now employed by corporate entities. Physician ownership or control of these systems is rare, which means decisions about how care is provided (schedules, volume, metrics, workflows) are being made my administrators & the C-suite, NOT practicing physicians.

Care becomes dictated by algorithms built to maximize profit and cut costs. Try explaining to an admin why an overwhelmed new mom w/ a UTI needs more than 5 min. On paper, she is 29 and “healthy.”

3. Giant Health Systems Have No Soul

That big health system didn’t grow up dreaming of being a doctor. It didn’t spend its 20s in med school & residency. It doesn’t sit across from patients & their families and break bad news.. In short, it DOESN’T CARE. It is a corporation that exists to generate profit.

Solo docs are also running businesses and trying to make a profit, BUT we are humans. We interact with our patients daily. If we make decisions that short-change them, it is OUR professional integrity, personal reputation, financial success & pride in our work that is on the line. In short, we care.

4. It’s NOT A Free Market

Because the majority of healthcare is insurance-based and your insurance plan is typically determined by your employer AND you don’t have the ability to interview or “shop around” for a doctor the way you might for other services, there is less pressure to compete for customers compared to other industries.

No one cares to “wow” you w/ their customer service because they don’t need to. If a system owns half the doctors in town and maintains their insurance contracts, patients will keep coming despite the 1 star reviews for long waits, mediocre care and rude staff. How does this translate in an actual visit, you ask?

5. Low-Quality Care is the Industry Standard

Scheduling 15 minutes visits is standard in primary care, however checking in, taking vitals, rooming and asking all the system-required screening questions can easily take 10 minutes. That leaves 5 minutes (if you’re lucky) for listening, diagnosing, examining, treating and documenting. This is why most doctors burn out, run late, are rushed, don’t make eye contact, don’t seem like they’re listening, and immediately jump to prescribing treatment.

I believe it is delusional to believe it is possible to provide good care in this amount of time, yet it is the norm. So how do you avoid this?

Since the real problem is the structure of our healthcare system, the solution is to step OUT of the system.

In direct primary care, patients pay doctors directly in the form of a flat monthly fee, cutting out all the middlemen, mark-ups, red tape & obstruction of the free market.

DPC represents doctors and patients taking a stand against a broken system that shortchanges both of them.

DPC doctors are incentivized to keep you healthy, rather waiting until you’re sick & dragging you in for visits.

We offer full price transparency w/ labs costing >70% less than the inflated prices set by insurers & health systems.

We offer free Meet & Greets so you can freely compare options & CHOOSE your doctor.

When combined with a health share or high deductible/low monthly premium insurance plan, it can cost the same or less than insurance-based care.

It’s time for going to the doctor to NOT suck.

Join the movement.

Find a DPC doctor near you

If you’re in Houston, come see me at Juniper Modern Primary Care.

be well,
Sonia Singh MD

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