Optimal Billing

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Once upon a time, there was a very successful holistic and integrative medical doctor whose practice was so helpful to patients (in comparison to what the standard of care offered) that other doctors were threatened by him and would repeatedly attempt to use the police power of the state, via the state medical board, to destroy his practice. It happened one day that this doctor sought out the counsel and professional services of an excellent lawyer who was willing to defend him against the unjust and illegal actions of the bureaucrats on the medical board.  Now, we come to the point of this story. I need you, dear reader, to understand what was NOT the doctor’s first question. The doctor requiring the legal services of the lawyer did NOT ask the lawyer: “Do you take insurance?

Medical doctors have criticized lawyers over the years, but there are some fundamental practices used by effective and successful lawyers that could vastly improve health care for the sake of patients, were medical doctors to adopted them.  The arrangement of payment is one such practice which works in the favor of the client and which, if adopted by doctors, would cut costs and save countless lives representing as it does a significant step towards a successful health care revolution. Every other effort which does not address this fundamental topic is fluff.

Let’s examine this argument carefully and consider how lawyers engage: A meeting was set up where the doctor was welcome to spend up to several hours describing the circumstances of the harassment he was subjected to and the myriad lack of due process and discrimination. After he left, the attorney then researched the situation by accessing a legal database to review the applicable laws and case histories per­taining to the case. The attorney even contacted additional specialists in order to optimize his recommendations. When the doctor returned to consult the attorney again, a complete game plan was in place, which was considered the unique aspects of the doctor’s case and referenced printouts from legal database (precedents) which the lawyer researched on behalf of the doctor. Had the doctor had more financial resources, an entire team of specialty lawyers would have been invited to refine the strategy. In order to provide this high quality service, attorneys often work late hours andweekends. Why all this efficient and effective service?Because for the lawyers to make a fair profit for their professional services, they need to deliver results which impress. They are the true “results oriented” practitioners.

Now, contrast the initial work competitive lawyers (who rely upon success in order to be paid) do with what happens when you go for care from a medical specialist, perhaps an oncologist, with your newly-diagnosed life-threatening cancer. Most likely, you will while away hours in an uncomfortable and unsanitary waiting room with a herd of other diseased and dispirited cancer patients. When you finally get to see the oncologist, he will typically spend a shockingly meager amount of time reviewing your case (note the rare eye contact) and then, no surprise, he simply recommends the “standard of care” treatment which the average person in your general situation “should” get. Your chart then get filed and neither it, nor you are considered again until your follow-up visit. The chance of the oncologist devoting his after-hours time to medical or scientific database research cross referencing the specifics of your individual cancer and seeking to learn whether aspects of your unique case might merit innovative or non-standard treatments is, sadly, nil.  Also rare is the oncologist taking the humbling initiative of soliciting a second opinion from a wiser or more experienced oncologist. To have prescribed the standard of care not only suffices in your case, anything distinct from that can be construed as malpractice.

You have been processed and are now relegated to a program that may have little chance of making your life better. If chemo­therapy is offered, you will be stationed in a large room with as many other cancer patients as the doctor can recruit. Economies of scale apply for the oncologist to generate income and the less time he spends on the specifics of your case, the more patients he can process into that chemotherapy room with the one nurse who attends to you and the others. And here is the rub:the oncologist’s income is not effected by whether the treatment is pleasant or gut-wrenchingly nauseating, whether your hair falls out or your skin boils and indeed, whether you life or die, his pay remains the same. If the oncologist decides to work longer hours or weekends, it is typically motivated by the financial reward of seeing more patients, not working harder for the ones he has under treatment. The oncologist who works extra hours typically focuses on more quantity of patients, not higher quality of care for each individual patient.

How did we get into the situation where, as a client of a reputable lawyer, you are given personalized attention designed to accomplish specific objectives but even at the famous cancer hospitals, you are not much more than a component on an assembly line? The answer is that the lawyer does not take insurance. Therefore, the client can hold the professional accountable.  Who holds the oncologists accountable? The party that pays: the insurance company.  The patient, whose life is on the line, has no real vote.

The irony is that lawyers, not doctors, practice “outcome-based” care. Lawyers, not doctors, practice scien­tifically in the sense that new developments are incorporated into legal arguments as soon as the precedent is established. In contrast, the history of medicine is replete with examples where countless patient die needless deaths during the years between when a scientific medical breakthrough occur and it is finally voted to the status of standard of care. Lawyers have to remain current on the ever-changing laws and judicial rulings or they will lose and their reputation will suffer. In contrast, when doctors fail to implement new and innovative treatments, it is the patient, not the doctor who suffers and dies. The real health care revolution must allow physicians to servepatients at least as effectively as lawyers treatclients.

Sadly, while the example above cites oncologists, the situation is every more hopeless for patients of psychiatrists and the cards are even stacked against patients of primary care doctors as well as all other specialty practices.

Accordingly, all clients of Alternative Health Advocates, LLC  (AHA) understand that, like a premier lawyer, AHA does NOT take insurance and that all effort taken specifically on their behalf will be billed in 10 minute increments pro-rated at $150/half hour and accounted for in an itemized bill similar to that delivered by an attorney:  time spent, service accomplished, amount billed. This includes services which occur outside of in-office or telephone/Skype consultations such as but not limited to 1) review of additional medical records received from other doctors or hospitals,  2) medical research specifically related to treatment options; 3)team creation and consensus building on behalf of the client; 4) preparation of letters or reports to other caregivers for purposes such as continuity of care,  arranging follow-up scans, laboratory testing, consultation with other specialists,  insurance reports and pre-authorization efforts. A standard retainer of $3000 is required before the case is accepted by AHA.

Lawyers compete for business and service their clients in an arena where results count and their pay is dependent upon their client winning.  In contrast, your doctor gets paid the same amount whether you life or die. If you want to “beat” your disease, the strategic option is to find a competitive doctor and pay your doctor as you would pay a competitive lawyer.


For more information on how you and your loved ones can obtain superior health care,

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