The Gatekeeper: Claims Denied!
I wish I knew what I really had signed up for,
I wish I knew what would become of my soul,
when Managed Care, or should I call them “Damaged Care,”
threaten my livelihood unless I conform to their protocol.
I am a married man – a proud father of four,
the sole bread-winner in my modest single-family home
I drive my Honda to work everyday,
to hold my mantra of doing good in the world each day.
This particular morning, however,
the contrary was revealed to me by our group practice direct.
“You’re authorizing too many tests and consultations, Dr. X.
We live in an era of cost-effective medicine, and
You are hurting our practice. You must become
A team player.”
My medical knowledge and clinical judgment
are given supreme credibilty and respect.
However, when $$ is of the essence,
loyalties and respect are departed since.
And minimal contributors to incentives are quickly dismissed.
The Bottom Line, is now our mantra,
since the HMOs become the “doctors’ dilemma.”
They imposed their giant-selves on the troubled system, to
shift control out of our hands into their shareholders’.
They preach: doctors must provide “cost-effective care”
as they sit in a profit-seeking executive chair.
But the translation has long since been evident.
They mean: Only care that pleases our investor’s pocket.
Well, I say – Claims Denied!
I decline conforming to the new master’s wishes, which
ask me to compromise my Hippocratic Oath,
and provide my patients an inferior care.
I decline limiting my patients with multiple chronic diseases,
to visits lasting just fifteen minutes!
I decline knowingly providing Damaged Care
so long as its only beneficiary is the insurer.
I decline selling my soul to the devil for Incentives
as I, in return, must somehow compromise lives.
Why?
All for the sake of profiting an insurance company? …Claims DE-NIED!