Two doctors discuss why top functional medicine practitioners are dropping insurance. Insurance companies won't pay for preventative care, forcing patients to choose between expensive hospital visits later or paying out of pocket now for prevention.
What percentage of your business is through insurance versus direct pay?
It's been out of insurance for five years now. I left the matrix a long time ago.
There you go. And guys, if that kind of triggers, you're saying, well, it's not going to pay. Relying on your insurance company to pay for preventative stuff, it doesn't work. It's an investment. You're like paying for your gym. Your insurance company doesn't pay for that. So I will say 90% of the top functional medicine doctors, that people are really making a difference, they stopped taking insurance a long time ago. And they did that because the insurance company, the real business model is they're going to consume as much of the doctor's time as possible to get paid to make it. So the doctors want to do it and they're going to consume as much of your time as possible. So they create a lot of friction because friction makes the money because we throw up our hands and, and just give up. So that means your doctor has to have a couple people working for him or her in order to just manage talking to people at the insurance company. So it just doesn't work. So when I see a doctor says, you know, I have a better rate for direct pay. And if you want to go through insurance, I'm, you know, $1 billion an hour. Or better yet, I just don't talk to insurance companies because I like to help people. I kind of respect that. And it's not awesome, but none of us should need insurance to get quality medical care. It's just overpriced. I'll get off my soapbox after that.
But no, no, it's fine. And that's definitely my thought when I was leaving the matrix. You're always going to need insurance for the most part when you have the heart attack, which you hopefully never have, because the hospital systems, it's a rigged game. If you go into a hospital with a heart attack, they're going to ding you for somewhere between 50 and $200,000 if they pay in cash for it. So you definitely probably want to have insurance for that part. But the preventative side, it's not as expensive as you think. Most of the things I was talking about with Dave today, they're free. Go see a sunrise, put your bare feet on the ground, eat some protein and fish, like, whatever that means to you. You don't have to go super fancy for that. Like, a lot of these things are very simple, but if you want to do some of these testing, yeah, there's going to be some out of pocket cost for it. But I think one of the big challenges with the kind of the system is that it's just, it's the time you cannot educate somebody on circadian biology and talk about how are you going to use photomodulation to decrease your inflammation in a five minute office visit. Just not going to happen. There's going to be a number that they show you. Your blood pressure is high. Here's the blood pressure medicine. LDL seems high. Here's your high dose stat. Next patient, please. And that medicine burns out the doctors as well. And so the doctors who, you know, exit the system, they want to do the best for their patients and it often takes education. I mean, my whole job right now is basically just educating patients how the cardiovascular system works, circadian biology works. And ideally they don't really need me. After they learn the things I can teach them, they may still want to come by to get their blood test to see kind of like everything's getting better and is my arteries getting more elastic by doing these nitric oxide pometers. Great, happy to do that. But we're really trying to just educate the patient because you're your own doctor, you know what your body needs and when you get yourself in nature, things tend to get better.
