We’d probably all agree that medical care is a good thing. We’d probably also agree that people who provide patients with medical care are doing a service for humanity.
Why is it, then, that we seem to have such negative attitudes about the people whose job it is to help people pay for their medical care? I’m referring to insurers, of course. Insurers help people pay for medical care. You’d think we’d give them credit for that
Instead, it sometimes seems that we act as if they are the devil incarnate.
This month’s cover story, by Contributing Editor Gil Weber, M.B.A., on page 32, discusses a report on managed care, revealing a lack of understanding about dermatology by plan administrators and a lack of understanding of managed care by dermatologists.
Conflicting Missions
Medical insurers have a tough job. There’s an inherent conflict in their mission. They are charged with making sure their customers get access to the medical care they need. At the same time, insurers’ customers ask insurers to keep costs as low as possible. Insurers seem to do a surprisingly good job balancing these two dynamics. Insured patients generally have excellent access to the medical care they need. I’m not sure how we’d quantify it, but I imagine insurers cover things 90%, 95% or maybe even 99% of the time.
Why is it that we’ve come to hate managed care? Could it be that we notice only the conflicts? Do we naturally ignore the 90%, 95% or 99% of times that insurers quietly just pay? Might the few times when insurers deny something or put what appears to be needless hassles in our way stand out in our minds far more prominently than the far more frequent times when there isn’t a problem?
Negative Attention
Unfortunately, negative things get noticed, whether the subject is insurers, doctors or any thing else in our
lives. Consider that doctors provide extraordinarily good care 99.9% or more of the time, but the 1 in 1,000 problem is what makes the news.
Thousands of government services happen seamlessly every day, but one failure in a million instances, such as Hurricane Katrina, is all we can talk about. There are a billion devout Muslims in the world, but we’d think they are all violent based on the few of them who make it into the media.
Human brains are wired to ignore the ordinary and to pay attention to the standouts. Before we let our minds jump to negative conclusions about others, we ought to think about what we don’t see.
We physicians wouldn’t want the public’s thinking about us to be based on the rare problem that gets noticed. We’d have a hard time communicating with anyone who thought those problems were our norm.
Our ability to communicate with medical directors of insurance companies will be equally limited if we focus on thinking their job is to prevent access to care while they’re thinking their job is to give patients access to medical care.
Seeing the Other Side
Perhaps managed care is not our enemy. For the most part, insurers are there to help our patients pay us. The medical directors of these companies were our medical school classmates. Most of them probably cared for patients for years before moving into a position as a medical director of an insurance company. They can’t be all that different from us.
But because we tend to notice the negative, it is probably natural for us to think that they try to deny everything. I imagine they go home at the end of their days thinking positively about all the medical care they helped people get and about their efforts to keep that care affordable. Perhaps by recognizing their difficult dual role and treating them as partners in the delivery of care, we are more likely to achieve our shared aims of better health care for our patients.
We’d probably all agree that medical care is a good thing. We’d probably also agree that people who provide patients with medical care are doing a service for humanity.
Why is it, then, that we seem to have such negative attitudes about the people whose job it is to help people pay for their medical care? I’m referring to insurers, of course. Insurers help people pay for medical care. You’d think we’d give them credit for that
Instead, it sometimes seems that we act as if they are the devil incarnate.
This month’s cover story, by Contributing Editor Gil Weber, M.B.A., on page 32, discusses a report on managed care, revealing a lack of understanding about dermatology by plan administrators and a lack of understanding of managed care by dermatologists.
Conflicting Missions
Medical insurers have a tough job. There’s an inherent conflict in their mission. They are charged with making sure their customers get access to the medical care they need. At the same time, insurers’ customers ask insurers to keep costs as low as possible. Insurers seem to do a surprisingly good job balancing these two dynamics. Insured patients generally have excellent access to the medical care they need. I’m not sure how we’d quantify it, but I imagine insurers cover things 90%, 95% or maybe even 99% of the time.
Why is it that we’ve come to hate managed care? Could it be that we notice only the conflicts? Do we naturally ignore the 90%, 95% or 99% of times that insurers quietly just pay? Might the few times when insurers deny something or put what appears to be needless hassles in our way stand out in our minds far more prominently than the far more frequent times when there isn’t a problem?
Negative Attention
Unfortunately, negative things get noticed, whether the subject is insurers, doctors or any thing else in our
lives. Consider that doctors provide extraordinarily good care 99.9% or more of the time, but the 1 in 1,000 problem is what makes the news.
Thousands of government services happen seamlessly every day, but one failure in a million instances, such as Hurricane Katrina, is all we can talk about. There are a billion devout Muslims in the world, but we’d think they are all violent based on the few of them who make it into the media.
Human brains are wired to ignore the ordinary and to pay attention to the standouts. Before we let our minds jump to negative conclusions about others, we ought to think about what we don’t see.
We physicians wouldn’t want the public’s thinking about us to be based on the rare problem that gets noticed. We’d have a hard time communicating with anyone who thought those problems were our norm.
Our ability to communicate with medical directors of insurance companies will be equally limited if we focus on thinking their job is to prevent access to care while they’re thinking their job is to give patients access to medical care.
Seeing the Other Side
Perhaps managed care is not our enemy. For the most part, insurers are there to help our patients pay us. The medical directors of these companies were our medical school classmates. Most of them probably cared for patients for years before moving into a position as a medical director of an insurance company. They can’t be all that different from us.
But because we tend to notice the negative, it is probably natural for us to think that they try to deny everything. I imagine they go home at the end of their days thinking positively about all the medical care they helped people get and about their efforts to keep that care affordable. Perhaps by recognizing their difficult dual role and treating them as partners in the delivery of care, we are more likely to achieve our shared aims of better health care for our patients.
We’d probably all agree that medical care is a good thing. We’d probably also agree that people who provide patients with medical care are doing a service for humanity.
Why is it, then, that we seem to have such negative attitudes about the people whose job it is to help people pay for their medical care? I’m referring to insurers, of course. Insurers help people pay for medical care. You’d think we’d give them credit for that
Instead, it sometimes seems that we act as if they are the devil incarnate.
This month’s cover story, by Contributing Editor Gil Weber, M.B.A., on page 32, discusses a report on managed care, revealing a lack of understanding about dermatology by plan administrators and a lack of understanding of managed care by dermatologists.
Conflicting Missions
Medical insurers have a tough job. There’s an inherent conflict in their mission. They are charged with making sure their customers get access to the medical care they need. At the same time, insurers’ customers ask insurers to keep costs as low as possible. Insurers seem to do a surprisingly good job balancing these two dynamics. Insured patients generally have excellent access to the medical care they need. I’m not sure how we’d quantify it, but I imagine insurers cover things 90%, 95% or maybe even 99% of the time.
Why is it that we’ve come to hate managed care? Could it be that we notice only the conflicts? Do we naturally ignore the 90%, 95% or 99% of times that insurers quietly just pay? Might the few times when insurers deny something or put what appears to be needless hassles in our way stand out in our minds far more prominently than the far more frequent times when there isn’t a problem?
Negative Attention
Unfortunately, negative things get noticed, whether the subject is insurers, doctors or any thing else in our
lives. Consider that doctors provide extraordinarily good care 99.9% or more of the time, but the 1 in 1,000 problem is what makes the news.
Thousands of government services happen seamlessly every day, but one failure in a million instances, such as Hurricane Katrina, is all we can talk about. There are a billion devout Muslims in the world, but we’d think they are all violent based on the few of them who make it into the media.
Human brains are wired to ignore the ordinary and to pay attention to the standouts. Before we let our minds jump to negative conclusions about others, we ought to think about what we don’t see.
We physicians wouldn’t want the public’s thinking about us to be based on the rare problem that gets noticed. We’d have a hard time communicating with anyone who thought those problems were our norm.
Our ability to communicate with medical directors of insurance companies will be equally limited if we focus on thinking their job is to prevent access to care while they’re thinking their job is to give patients access to medical care.
Seeing the Other Side
Perhaps managed care is not our enemy. For the most part, insurers are there to help our patients pay us. The medical directors of these companies were our medical school classmates. Most of them probably cared for patients for years before moving into a position as a medical director of an insurance company. They can’t be all that different from us.
But because we tend to notice the negative, it is probably natural for us to think that they try to deny everything. I imagine they go home at the end of their days thinking positively about all the medical care they helped people get and about their efforts to keep that care affordable. Perhaps by recognizing their difficult dual role and treating them as partners in the delivery of care, we are more likely to achieve our shared aims of better health care for our patients.
