Urologists: In tough economic times, patients come first

March 1, 2010

How does your practice handle patients who don't have insurance or are experiencing financial problems?

Question

How does your practice handle patients who don't have insurance or are experiencing financial problems?

Respondents

Thomas E. Moody, MD
Birmingham, AL

James C. Pitts, III, MD
Louisville, CO

Galen F. Warren, MD
Cincinnati

Joseph Wyatt, MD
Pierre, SD

According to federal government figures, unemployment in the United States rose from 4.9% in January 2008 to 10% 2 years later.

With the loss of jobs comes a loss of health insurance for many Americans. While that loss of coverage may be temporary, it can leave patients without coverage when medical needs arise. Urology Times asked a number of urologists around the country if they were seeing any increase in uninsured patients and if their practices have a policy for dealing with those who are uninsured or suffering financial hardship.

The problem is worse in some areas of the country, and some urologists report they are able to do more to help the uninsured than others feel they have resources to offer. All of the urologists say they try to help uninsured patients, but most establish some guidelines.

Samuel Attia, MD, has seen an increased in uninsured patients in his solo practice in Houston. He tries to help as much as he can, but he also uses community resources.

"We do take care of the patient who doesn't have insurance. They have to pay at the time of the visit, but we do give them some discount," he said.

"If their condition is serious and they require surgery, our hospital here is a nonprofit organization that has an allocation for patients who are hurting financially. We would have to donate our services there, which is difficult in a small practice. So the other option is the public hospital. We will refer patients there, where they charge according to the patient's income, and if they find out the patient actually has money, they will charge them."

Dr. Attia says he also takes into consideration exactly who the patient is.

"If it's something I can offer in the office, I can offer a discount rate. If it's an old patient of mine who happens to be having trouble and their employment situation is holding them down right now, I might treat them free, because I know that when they get back to work, they'll come back to me.

"But if it's a new patient who walks in and doesn't have insurance, then we will send them to the public hospital," he explained. "We do get illegal aliens here, and often, even if it's legal immigrants who are diagnosed with cancer or something else serious, they'll return to where they came from, where the medical care will cost less."