Is a Cash-Only or Direct-Pay Medical Practice for You?

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I was sick of insurance, billing software, employee overhead, etc.. So I opened a walk-in chiropractic office with no employees, no billing to deal with and a very low overhead so I can charge just $20 a visit and make more money and have more fun then when I was charging $70-200 a visit with insurance. Build it and they will come!
Jeffrey Clark DC
www.BigIdeaChiro.com

Jeffery Clark DC of NV 1:48AM September 24, 2010

Doctors deserve the big bucks they charge even for the simplest procedures. They invested years and thousands in learning all of medicine.
But why pay them for total knowledge when simple knowledge any person can learn quickly and render for average wage does the job?
For example- As an army combat medic I learned to suture in 3 minutes. The only trick necessary is tying the knot. I learned intravenous cut-downs in 5 minutes and emergency thoracostomy with one experience, and after a week of mass casualties I could do anything a doctor could do.
What we need is large numbers of medical specialists requiring little time or expense to train. Let Doctors diagnose. Let technicians perform the surgery.

Gary E. Holland of WA 3:21PM July 04, 2010

I am with td 39. Americas strength has always been in expertise, specialization, and competitive pricing based on advertising. Since Americans let insurance companies between them and the doctors things have become outrageously expensive. There are places that specialize in particular procedures, are good and not overly expensive. I just got a couple of quotes for the same procedure one was for $12,000, the other for $54,000! and the former place had way more experience. Go figure. If this information was easily available and everyone was running their own health budgets, prices would quickly come down.

cheers of VT 6:52PM June 29, 2010

I am nearly 65 and have acquired 6 chronic disorders. Doctors can do nothing for me. So, I did it for myself.
I devised my own treatments using simple compounds available without prescriptions using them in ways not yet known to most Doctors. I am in complete remission with 5 of them and have learned to enjoy the sixth. My vasomotor rhinitis gives me frequent hearty sneezes and mucous cleansing nose blows daily. I haven't suffered a single upper respiratory infection, not even a common cold, since I acquired the disorder 25 years ago. It's not a disorder to me. Its a powerful immune response that keeps those nasty viruses and pneumococci sneezed out of my respiratory system. I like my chronic disorders. I have no discomfort or disability of any kind.
The nice thing about chronic disorders is that once diagnosed one can stop paying doctors for a cure. Accept and ameliorate. It's cheap.
Looking forward to old age, dying and death. Just as nature intended.

Gary E. Holland of WA 6:39PM April 08, 2010

When I lay dying of infectious hepatitis (in India) the hospital wanted $ 11,000 up-front to put me on Intravaneous in the hospital for 2-3 months. I had no money.
I wandered off to find a place to lie down and fall back into delirium. I passed a tiny hole-in the wall merchant selling herbs in green bottles. He pointed to my yellow eyes and held out something green. "Smoke this," he said. Before I collapsed, I manged to smoke a few puffs. 5 minutes later my nausea disappeared and I could swallow water for the first time in many days without wretching it back up.
He charged me one U.S.Dollar. After a few days of smoking and sipping I re-hydrated and survived. No thanks to western medicine.
10 years later an American hospital wanted to do an emergency appendectomy for $15,000. I told them to wait until my fever rose another degree or my pain became excruciating. The Doctor looked at me like I was an idiot. Minutes later my body said, "tickle me here, over the appendix." I tried it. It felt good. Then it said,"push." I did what it suggested moving from side to side, deeper and deeper, until suddenly something gave way and I felt a flood of relief fill my body. I continued following my body's guidance and massaged long and deep. 20 minutes later the fever dropped a full degree and the pain reduced by 50%. I went home and recovered fully and saved myself another hospital bill.
Since then I diagnosed and surgically removed a Dermatto Fibroma from my wrist and saved $750 using a topical surgery technique any fool can use painlessly and nearly bloodlessly in their own home. I call it Hydro Abrasion. (hint: what happens to skin when it is soaked in water?)
Years later I performed Needle Apponeurotomy for Dupuytrens Contracture and successfully severed the abnormally thick fascia preventing me from openning my hand fully. And I did it one handed and left-handed. I saved another $1,000.
The list of do-it-yourself successes is 35 years long. If I can think and do for myself I trust other's can also.
15% of all medical diagnoses are false. Doctors lack the time to think long hours about individual patients. And they are ostracized if they dare think outside the box to solve for the unknown. They don't have access to the subtle feelings of another person's body. There are clues they miss.
WARNING: No person should attempt to diagnose and treat themselves without learning the symptoms of a life threatening situation thoroughly. Never make a diagnosis without doing your homework. Recognize quickly when you are wrong. Always have an alternative if you fail. If you fail, then go to a Doctor. If your experience is similar to my own you will succeed 90% of the time. Doctors are intelligent and knowledgeable. But to solve for the unknown one must use the intelligence intelligently. That takes lots of time to think. Doctors don't have the time. The patient does.
Meanwhile, thinking for myself.

Gary E. Holland of WA 5:47PM April 08, 2010

Your're apparently the exception. Live long enough and you won't be 'chronically healthy'. Usually, everone gets chronically sick! Just ask my 6 year old son who was recently diagnosed with Type 1 DM. You should place a medical degree on yourelf with gold ribbons, throw in a parade, if you can diagnose yourself 90% of the time! Just be careful of that 10% of the time that you can't diagnose yoursef using google! Don't want to miss anything life-threatening that even doctors miss sometimes. Just don't get more than the common cold or an abscess that needs incised and drained without insurance. Read my other comment. Good luck with Google search engine.

Hightower of OK 6:33AM April 07, 2010

As a cash paying patient I don't wan't to pay more for my service than is charged to an insurance provider. If anything, I deserve a discount.
I have analyzed cash versus insurance and determined that for the majority of us who are chronically healthy and medically knowledgeable insurance premiums cost more than they reimburse by about 10 to 1.
Since all medical knowledge is free to everyone on the internet I can diagnose and treat my own disorders 90% of the time. When I need a procedure or prescription I go to a physicians assistant, who provides what I need 90% of the time. As a result I have been to a doctor only once in my life and paid only 20 dollars. But I have saved over $ 95K on insurance premiums I never had to pay.
Now I own my own health care trust worth $ 95K.

Gary E. Holland of WA 7:26PM April 04, 2010

Totally agree with your concept; however, you won't legally be able to see Medicare patients in the ER (in-network doctor) and charge any Medicare patient you see with your cash practice? Stupid rule, but that's the law. Not sure if private insurance works this way. To charge cash to any Medicare patient you have to opt-out of Medicare for two years. Read blog on Medscape about this. Good luck!

L.W. Hightower of OK 5:00PM April 04, 2010

CE Richardelle of MS
"but I keep being told that I'm selfish for not wanting to work for free
when I'm done. How is that fair for me?"
Your darn right it's selfish! But just maybe that's a good thing. Read Atlas Shrugged by Ayn Rand.

Phyll of GA 3:03PM March 25, 2010

I am entering medical school in August of this year. My ultimate plan is to live in a small city, work 2 days a week in the local ER, and have a small cash practice. I have kept my debt low, will live on my husband's, income, and will be fortunate to be able to use my residency salary to pay off my student loans which will still be over $100k. With no debt at the end of my training, I will be able start small and grow my practice. Most American med students are not that fortunate.
I believe that true equality in medicine is equal pricing for all. These are scary times for doctors, and I believe America has been lied to. A couple of fellow students have even talked about practicing in Mexico or even further south where doctors are not sued and are paid in cash. America, there's no such thing as a free lunch. Med school and liability costs are enormous, but I keep being told that I'm selfish for not wanting to work for free when I'm done. How is that fair for me? A cash practice would make a basic medical visit cheaper than a pack of cigarettes and a night at the bar. It sounds fair to me.

CE Richardelle of MS 3:57PM March 21, 2010