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Self-Pay Vs. Insurance

Sometimes, you just want to go to a dermatologist and say, "what is this spot on my face and what do I do about it?"

by
Helen Smith

Bio

September 13, 2012 - 8:42 am

Every time I go to a medical procedure that is not covered by insurance, I have a much better experience. While this is not unusual or unexpected,  I am always surprised at the difference. Today, I went to the dermatologist to have some skin treatment and to have them look at some spots on my face. Grand total: $75 out of pocket but more importantly, the treatment I got going to the side of the office that was self-pay was so different than the treatment received on the other side where the insurance patients sat.

I strolled into the left side of the office at my designated time and only one person was ahead of me. I looked through the door to my right at about twenty or more patients waiting on the other side with a couple of slightly harried-looking receptionists dealing with them and the paperwork. Last time I was there, I went to the ”insurance” side. It wasn’t fun. It was tedious with paperwork to fill out, annoyed tones when I asked a few questions and a rushed session with a nurse practitioner where half my questions weren’t answered. This time, in the self-pay area?  A polite assistant took me to a back room immediately, asked me how my day was and brought in the aesthetician to work her magic and look at the spots on my face. There was no rush and I left feeling happy and relaxed. Yes, I know going to the cosmetic side is much different than doing an actual medical procedure but honestly, not that much. Sometimes, you just want to go to a dermatologist and say, “what is this spot on my face and what do I do about it?”  You just typically won’t get a cheerful reply or good treatment when you ask.

A couple of weeks ago, I went to a dental procedure with an oral surgeon; I had to pay the entire bill out of pocket as it is not covered by insurance. Though I did have to do some waiting while they worked me in, they were kind, cheerful and extremely competent and concerned about my well-being. After I got home, my dentist and surgeon sent me some beautiful flowers to help with my recovery. The whole experience was so much better than I thought it would be. That is rare to say for any doctor’s visit I have gone to over the years. More often than not, there is waiting, a brisk appointment with a harried doctor or nurse and more waiting while the staff looks at you like you are a leper. The other patients look depressed, angry and sick or just pathetic while you wonder how and why you are such a sicko yourself.

I cringe when I think about ObamaCare and how much worse it will get and I just pray that my health holds up long enough to escape sitting through what will probably be hours in an anonymous setting full of too many people needing too much care and filling out too much paperwork. Or worse, being denied even the “privilege” of sitting through such hell. I hope that with ObamaCare there will come more practices signing up for concierge service where self-pay will buy a better standard of care. But is that really the answer? Maybe it is, but then the care becomes even more divided,  just like my dermatologist’s office where the self-pay people have one type of care and those with insurance another. Wasn’t ObamaCare supposed to bring us equality?

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Image created courtesy photo via shutterstock /  Cheryl Casey

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Helen Smith is a psychologist specializing in forensic issues in Knoxville, Tennessee, and blogs at Dr. Helen.
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