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Hard to survive charging $5 per visit

Last November, several news outlets carried a story about Dr. Russell Dohner of Rushville, Ill.

Dr. Dohner takes no insurances, works 7 days a week, and charges $5 per visit. I respect that. I really do. I wish I could give care to all in need.

The article brought out a lot of comments wondering why all doctors can’t be like him because obviously he cares about patients. Unfortunately, most of the stories about him don’t mention his financial backing until the bottom third of the story – long after most people have stopped reading and moved on to other things. It says he’s primarily supported by a farm that his family owns, allowing him to practice at $5 a person.

If I had enough money to support my family and practice independently, I might do it, too. I like this job. I always have, and hopefully always will.

But the financial reality is that I have kids (Dr. Dohner has none) and a wife (ditto). My two staff members also have families to support, and they can’t work for free, either. So I have to charge people their copays, and bill insurance companies for the balance, and hope I can collect enough to keep my door open. This isn’t just medicine: It’s any business model. No matter how much you love what you do, it’s the rare (and lucky) person who can continue doing it for practically nothing.

Charging for your services isn’t a sign of not caring. It’s a sign of having the same responsibilities that your patients do. In a perfect world, perhaps medical care would be free (or even unnecessary). But our world will never be perfect. And I’ll always have an overhead (both business and personal) to meet. So, to keep caring for patients the best I can, I’ll have to keep charging them.

Dr. Block has a solo neurology private practice in Scottsdale, Ariz.

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Last November, several news outlets carried a story about Dr. Russell Dohner of Rushville, Ill.

Dr. Dohner takes no insurances, works 7 days a week, and charges $5 per visit. I respect that. I really do. I wish I could give care to all in need.

The article brought out a lot of comments wondering why all doctors can’t be like him because obviously he cares about patients. Unfortunately, most of the stories about him don’t mention his financial backing until the bottom third of the story – long after most people have stopped reading and moved on to other things. It says he’s primarily supported by a farm that his family owns, allowing him to practice at $5 a person.

If I had enough money to support my family and practice independently, I might do it, too. I like this job. I always have, and hopefully always will.

But the financial reality is that I have kids (Dr. Dohner has none) and a wife (ditto). My two staff members also have families to support, and they can’t work for free, either. So I have to charge people their copays, and bill insurance companies for the balance, and hope I can collect enough to keep my door open. This isn’t just medicine: It’s any business model. No matter how much you love what you do, it’s the rare (and lucky) person who can continue doing it for practically nothing.

Charging for your services isn’t a sign of not caring. It’s a sign of having the same responsibilities that your patients do. In a perfect world, perhaps medical care would be free (or even unnecessary). But our world will never be perfect. And I’ll always have an overhead (both business and personal) to meet. So, to keep caring for patients the best I can, I’ll have to keep charging them.

Dr. Block has a solo neurology private practice in Scottsdale, Ariz.

Last November, several news outlets carried a story about Dr. Russell Dohner of Rushville, Ill.

Dr. Dohner takes no insurances, works 7 days a week, and charges $5 per visit. I respect that. I really do. I wish I could give care to all in need.

The article brought out a lot of comments wondering why all doctors can’t be like him because obviously he cares about patients. Unfortunately, most of the stories about him don’t mention his financial backing until the bottom third of the story – long after most people have stopped reading and moved on to other things. It says he’s primarily supported by a farm that his family owns, allowing him to practice at $5 a person.

If I had enough money to support my family and practice independently, I might do it, too. I like this job. I always have, and hopefully always will.

But the financial reality is that I have kids (Dr. Dohner has none) and a wife (ditto). My two staff members also have families to support, and they can’t work for free, either. So I have to charge people their copays, and bill insurance companies for the balance, and hope I can collect enough to keep my door open. This isn’t just medicine: It’s any business model. No matter how much you love what you do, it’s the rare (and lucky) person who can continue doing it for practically nothing.

Charging for your services isn’t a sign of not caring. It’s a sign of having the same responsibilities that your patients do. In a perfect world, perhaps medical care would be free (or even unnecessary). But our world will never be perfect. And I’ll always have an overhead (both business and personal) to meet. So, to keep caring for patients the best I can, I’ll have to keep charging them.

Dr. Block has a solo neurology private practice in Scottsdale, Ariz.

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