Separating the business of optometry from the desire to help patients

(image credit: Adobe stock/PCH.Vector)

I think it’s good practice to sit back and look at oneself from time to time with as much objectivity as is possible. For that reason, I look at different aspects of my practice periodically. A conversation with another OD at a recent conference spurred me to revisit this exercise. I specifically examined my patient database with regard to insurance coverage and found that 63% of my patients have Medicaid as their primary insurance. The topic of conversation with my colleague was reimbursement, and he asked me if I accepted Medicaid. When I replied that I do, he said, “I sure am glad I don’t have to take Medicaid.” True to form, I said tongue in cheek that I was glad he didn’t have to either.

After the brief conversation ended, I had a little chuckle to myself before briefly reflecting on the topic. Then, of course, everything I “should have said” came to the tip of my cerebrum. Frankly, no one has to accept any insurance they do not want to accept. This is a free country, after all. I just happen to be lucky enough to own and steward a 75-year-old practice in which 63% of my patients rely on the state of Georgia for their health insurance coverage. I love my patients—very much—and I love what I do. I fight for fair reimbursement just like everyone else, and I do not own a nonprofit business. Am I going to knock someone for not accepting Medicaid? Of course not! Am I going to write an editorial in defense of accepting it after being backhandedly insulted by a tone-deaf remark? Of course!

My residency was in ocular disease, and unfortunately the presence and rate of disease and socioeconomic status are related. Therefore, it works out that I have the opportunity to treat more disease in my patient base than in other patient bases out there. Simply put, in the area in which I practice, it makes sense for me to accept the insurance that I accept in order to practice the way I practice. Nothing is cookie cutter, and I speak only for myself. My situation just seems to work for me—nicely.

No, I do not accept all insurances and vision benefits. In fact, I recently parted ways with one vision benefit provider a few months ago, but that is a separate editorial all together—one which I will likely not be writing. Do I have a great business mind? Not really. Do I enjoy helping people? Of course. We all do. Do I feel the need to apologize for accepting an insurance provider that someone else is “glad” they don’t “have to take”? Not one bit. Am I getting overly defensive on behalf of myself and my patients and probably just need to let it go and wrap up this editorial? Likely so.

Benjamin P. Casella, OD, FAAO,
Chief optometric editor, practices in Augusta, Georgia, with his father in his grandfather’s practice.
Email: bpc81@aol.com Phone: 706-267-2972