DR. HOOK- Pay up! Dealing with deadbeat patients

Valentine cards, birthday cards, pen-pal letters– few of these come in the mail anymore.  

I feel like Charlie Brown going to an empty mailbox. Sigh. Actually, that isn't totally true. I do get bills. And I don't mean "I'm just a bill, yes I'm only a bill, and I'm sitting here on Capitol Hill" bill. I mean "Pay up, buddy" bills.

I pay both my medical practice and my home bills every weekend, but come Monday morning, I get more bills.  It's like that Cary Grant movie, Mr. Blandings Builds His Dream House, which becomes a money pit: It never ends.

So what does a struggling physician do these days when his patients won't pay their bills? Some say prescribe medicines that don't let them enjoy sex, but that would be against the Hippocratic Oath. Darn.

 Over the years, I've learned to identity patients who don't, or won't, pay their medical bills. 

Danger Sign #1:  Sample scroungers 

"Doc, give me samples. I know you have five billion in your tiny closet."  

So I give them about $500 worth of samples, and later my staff tells me that they didn't pay their $15 co-payment– or the past 18 co-payments. For some reason, they couldn't squeeze their platinum AmEx card out of their Louis Vuitton wallet.

Danger Sign #2: Couture and luxury cars 

In LA, everyone drives an $80,000 car but lives in a 900-square-foot apartment. People Suze Orman describes as folks who "spend beyond their financial means to impress people they don't know or even like" won't pay their medical bills. They assume the doctor will keep taking care of them, refill all their prescriptions (and give samples), and answer all their phone calls– unlike the mean car dealer who'll take away their Mercedes for the first missed payment.

Danger Sign #3: Rudeness  

Who says you catch more flies with honey than with vinegar? I watch those debt consolidator commercials in which the in-trouble person is always politely saying, "Oh, I'm sorry. I'll eventually pay you when I have some money."  

According to my billing agency and my staff, those commercial actors need to be fired! What they tell me is they usually get a Click – Dial Tone or "I don't have time for this! And no I won't go on an interest-free payment plan!"  

One dude had the audacity to show my staff person that he had $4 million in his checking account from just closing a deal, but he wouldn't pay his $300 bill. (Maybe it was Monopoly money?) He told my staffer, "Deal with it!"

Danger Sign #4: Lots of emails and phone calls 

I don't know if it's a subconscious thing, but non-paying patients seem to push the limit to see how far they can get away with things. They email medical questions every day, call to find out unnecessary things like what is considered normal body temperature and why does that Plavix  commercial have that fake doctor answering questions to a fake patient, and demand to have forms filled out from DMV Handicap Parking to a million-dollar life insurance policies.  

Danger Sign #5: "Doc, don't put this in my medical chart."  

When patients don't want me to request medical records from a previous doctor, bring in their own previous records with missing pages and a lot of White Out, or request I not document certain important medical conditions they have, I feel like Chief of Staff at the White House.

One patient said he didn't want to pay his bill. I asked him if he would work if his customers didn't pay their bill. He responded, "Hell no!" He then grinned and coughed– up the money.  

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.