Physicians' Practice Displaces Insurance Doctors Seek More Time with Patients, Not Bills

Article excerpt

Byline: Sarah Skidmore, Times-Union business writer

Cindy Flanders and Kay Holmes want the time to spend with their patients, they want the sensation of waking up and loving their jobs, and they want their furniture to show up.

They were setting up the office for their new practice that opened this week in Southside and talking about what they see as the future for their practice. They want to bring back some of the patient relationship that they say has been lost in the years of managed care -- such as talking to a doctor when test results come back and being able to see patients without feeling rushed.

"We want to be the doctor again," Holmes said. "It's sort of a return to old-fashioned care for the patient."

At the large group practice they left, they were seeing nearly twice as many patients as they'd like to pay for the staff to handle the insurance. So they decided to open their own smaller practice without the influence of insurance.

Everyone's welcome, but if patients want to bill insurance for the visit, they need to handle it themselves. The office staff is ready to provide the necessary information and assist with the paperwork, but the decision to bill and primary responsibility will be with the patient.

"It will be new for all of us," Flanders said. "It sounds a little scary, but it's just a simpler way to do medicine."

The physicians aren't part of any insurer's network of physicians, so patients may have to pay more for the visit or pay for the entire bill.

Flanders and Holmes feel it is a business model that can work.

"People will go to get their nails done and their hair done. If health care is a priority to them and they want a little more time with their physician, then they will be willing to pay for it," Holmes said.

They have the loyalty of patients who have followed them from other practices during their more than 15 years each as gynecologists. They also had some patients who already were paying out of pocket to see them at their practice at the Mayo Clinic.

It's a different kind of business model at a time when insurance often dominates many health care facilities.

"What these physicians are doing is a response to the frustration felt by many physicians as a result of the constraints imposed by the health care environment that we function in," said Neel Karnani, a local physician representing the Duval County Medical Society.

"Physicians in other parts of the nation that have a higher penetration of managed care have taken similar steps successfully. It was not so long ago that physicians did not have a huge number of staff to do their billing," Karnani said.

But the move away from handling insurance is not the only thing that's different at the new practice. The exam rooms are bigger. The gowns are thicker and less revealing. The office sign has just their names -- no mention of gynecology. …