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In Network, Out of Network, Who Cares?

Daniel Paull MD explains that there are a whole host of medical providers in the country, but that you're only allowed to see a select few of them, if you are trying to use your insurance.

September 22, 2022

In network, out of network, was in network and now is out of network.

The facility and surgeon are in network but the pathologist is out of network.

If the above sounds confusing, that’s because it is.

There are a whole host of medical providers in the country, but you are only allowed to see a select few of them if you are trying to use your insurance. Maybe you find some docs who you like, only to find out at the next visit that they no longer take your insurance, meaning that they are now “out of network”.

So maybe you go and find another doc who you like, only to undergo the same process a year later, when either the insurance changes again, or the doc you liked is no longer there.

It’s hard for patients to keep a doctor these days as insurance shifts are frequent, and turnover is so high. This leads to discontinuity in care, which in many cases leads to worse care.

 

It's hard for patients to keep a doctor these days as insurance shifts are frequent, and turnover is so high. This leads to discontinuity in care, which in many cases leads to worse care. Click To Tweet

 

We should get used to this process accelerating, meaning that physician turnover will increase to keep pace with physician burnout.

All of the above mentioned issues are health insurance related.

Remove the health insurance and provide transparent affordable cash pricing, and you have an un-burned-out doctor who has a stable practice and can provide higher quality care.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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