flstf

Having recentlly moved to a new state, I am trying to choose a new Doctor and Dentist. I have high deductible insurance so I am very interested in price as well as quality.

I am curious how others have gone about making these choices. I have been unable to obtain good pricing information so far. I have yet to talk to anyone who selected their Doctor or Dentist using costs as one of the considerations.

It seems as if costs do not matter to most people. Surely there must be some difference in how prices are set by Doctors and Dentists and some way to evaluate them.

kurty[B]

For me, it depends on the type of insurance I have. With my current HMO they lay out which doctors I can go to and get a good rate. Unfortunately, I have yet to find a doctor in that plan that I don't feel is just peddling the latest and greatest prescription that does nothing for me, so I reluctantly go to the doctor. As far as dentist... I don't have much info for finding a dentist. But I have had lots of luck with private practices there!

My girlfriend goes to the local hospital and asks what doctor they would suggest for certain things, and they usually give her a list of two-three doctors, and then she calls them and see who appears to have the friendliest staff.

flstf

Thanks kurty[B]. I have talked to the Medical/Dental associations and they will give out a list of doctors/dentists in my area but no pricing information. When I call the various offices and inquire about pricing I usually can't get past the receptionists and cannot get good pricing information.

As long as we consumers do not pay attention to the price we pay for medical/dental, I fear the costs will continue to rise dramatically. What incentive do the doctors/dentists have to offer good service at a reasonable price? There seems to be no competition, at least based on costs.

flstf

I just did a search on google with the question "How to choose a doctor". There are dozens of hits and not one of them listed costs as one of the criteria for making a choice.

Doesn't anyone care what they are paying for health care? It seems like everyone acts like they have unlimited money when it comes to making these choices. With this kind of attitude, I'm surprised that medical costs aren't rising even more than they are.

yellowchef

you should have an 1800 number on your insurance/dental card.. they will be able to give you a list of drs and dentists that not only accept your insurance but that are in your area. You might also be able to get pricing information through them since they do business with them and see the charges and statements. Blue Cross Blue Shield of FL has a website that lists the doctors in my area that take my insurance. I have a $10 co-pay no matter what so while I could inquire about the cost it would be useless. I get my statement and it tells me that I paid damn near $1000 for some bloodwork. Ive never had a problem getting pricing information from receptionists. They usually tell me theres $$$ for the consult/check up fee and you can go from there. At the consult they can tell you whats wrong and especially dental they can give you a written estimate for the work they will need to perform and you can accept or decline it. If you dont like the consult.. no harm no foul and they'll have to send their results to the next doctor/dentist and you might be able to avoid consult fees again.

thingstodo

I agree with the previous post. The most important thing is quality. I think the prices run very similar these days. Most companies pay based on pre-negotiated rates, so pricing doesn't really mean much unless you've established the patient/Dr. ralationship first. Just get someone that uses your coverage or you will pay out the nose.

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uncle_el

what you should look at is word of mouth... those people you know in your area, who do they go to? what do they have to say about the health care services in your area?

the cost is almost irrelevant, seeing as you have insurance, you should be paying the same co pay for each dotor's visit. besides the fact, a low cost doesn't mean good or bad doctor/dentist, nor does high cost mean good or bad doctor/dentist.

just the opinion of one medical student...

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flstf

The insurance I have is $5000 deductible for my wife and myself at $330 per month so I guess the costs become irrelevant after the first $5000.

The statement that the cost is irrelevant may be one of the reasons that health care costs are out of control. It seems to me that there must be competition for a free market system to work otherwise the government eventually may/will step in and take control like they do with monopolies.

flstf

Thanks, I will contact Anthem Blue Cross and get their list(s). I think I am beginning to see that most medical costs are being set by insurance companies. I guess if you have no insurance they can/will probably charge you a lot more.

yellowchef

heres the anthem site I found http://www.anthem.com/jsp/antiphona/home.jsp

heres the BC/BS site www.bluecares.com

and heres the Anthem directory page http://providerdirectory.anthem.com/main.asp

VitaminH

Here's a thought. Go to a local pharmacy and ask the pharmacist what he thinks. Sometimes they may not tell you anything as a matter of professional courtesy and they don't want to burn any bridges so to speak, but sometimes they can give sound advice. Other than the nurses, odds are no one interacts witht he doctors more than the pharmacist, especially if it's in a small area. Price wise, they probably won't be able to help much, but as far as quality of care they can probably give you the scoop.

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alpo

flstf - As a doc, I can honestly say I do not know what one person will pay for a service. The prices are dictated by the insurance companies. Usually your copay will be set at a certain level so you are only required to pay a small fee. The insurance company will dictate what they think is "fair and customary" for a certain procedure or level of care in your area. It's pretty easy to for them to say that a performing a procedure, like a colonoscopy, should be a certain fee based on the cost needed for medicines, equipment, etc. It's a lot harder to figure out how your doc should be compensated for managing your diabetes, high blood pressure, and depression. Is my knowledge, training, thought about you and your medical problems worth as much as the service provided by the person who does a procedure?

As far as finding a good doc, I'd say ask around amongst your friends. If one of them has a doc that they like, go see them. You have to feel comfortable with the person who is treating you. We often ask people to share some of the most personal things about themselves they have -- if you don't feel comfortable sharing those things, your doc will not be able to doing everything they can to give you good care. I cannot say that pharmacists in particular would be able to give you a good idea about good physicians. Although I am a physician, I cannot honestly say I speak with pharmacists (outside of my hospital) all that much. When you call most pharmacies nowadays, you just leave your prescription on an answering machine.

If you are looking for relatively cheap care that is likely to be pretty good, go to a resident run practice at your nearest teaching hospital.

flstf

Thanks alpo. Am I right in assuming that the majority of health care costs are currently being determined by the insurance companies? As a doctor do you think this is working or should the government come in and take control? I have read of cases (lawsuits) where hospitals are charging uninsured people much more than those in the insurance pools.

I am currently working with Anthem to set up a HSA account where anything up to $10,000 will be paid by me each year until the deductible is exceeded. Of couse I want to spend as little of the $10K deductible as possible so the cost of health care becomes very important. That's why I'm trying to evaluate the best cost/quality of the doctors and dentists I choose. I'm not sure Anthem will care about the costs until I exceed the deductible (if ever) when they have to pay something.

uncle_el

the government and hmo's are already in control!! insurance companies, hmo's, and the government (via medicare, medicaid, etc.) set the price of what they will reimburse a physician or dentist.

besides that, there are so many things to add up when calculating a cost for a particular service. for instance, if you come into a general practioner's office for a sore shoulder you hurt during a basketball game... your copay may be $10 or $20... but there's the receptionist's salary, the nurse's salary, the physician's time to evaluate you, the cost of an x-ray... not to mention what the physician should or shouldn't charge for his/her hourly fee (traditionally, there is no hourly fee for physicians). so, you may only pay 20 bucks, but the cost is much more than that. the physician will likely be reimbursed a good portion of the cost of the x ray via insurance. but that doesn't account for the salaries of the receptionist, nurse, and physician him or herself.

a big reason i don't want to go into private practice... in medical school we're taught how to treat patients, but not how treating patients can be a profitable business.

i can come up with a lot of reasons why healthcare costs are rising (the cost to attend medical school, years of research to develop new technologies, high speed computers needed for imaging & storage...) but i digress.

honestly, i think the best thing you can do is to talk to people in your area and see who they like. if you can find a physician and dentist who pleases you, and you're able to develop a good rapport with, you will have good health care. it's a two way street that too many times we dismiss. i don't think you should look at the financial bottomline when choosing someone to help you in your healthcare decisions, but rather your trust in that person or persons.

__________________
An individual who breaks a law that conscience tells him is unjust, and who willingly accepts the penalty of inprisonment in order to arouse the conscience of the community over its injustice, is in reality expressing the highest respect for the law. - Martin Luther King, Jr.

The media's the most powerful entity on earth. They have the power to make the innocent guilty and to make the guilty innocent, and that's power. Because they control the minds of the masses. - Malcolm X

flstf

Thanks uncle_el. The way my insurance is and will be set up with a HSA is that I have no copay and will pay for everything up to the deductible (now $5000 and soon to be $10000). I am simply trying to shop for health care services like I would for anything else and compare prices with quality.

I have worked in engineering for many years and I know that the best engineers are not always the highest paid ones. I assume that doctors and dentists can be evaluated as well. You know, some will charge less and some will charge more for the same quality. It seems like this information is hard to get since most people are only concerned with the amount of copay and/or deductible.

I think I am beginning to see that the medical industry is not really a free market and is already regulated to some extent by insurance companies, etc. I'm not sure that having our health care in the hands of insurance companies is a good thing. I wonder if we shouldn't open it up to competition or failing that just let the government provide the service and regulate it even more.