Nearly every healthcare professional undergoes a white coat ceremony and during that ceremony, normally fairly early on the journey, an oath is taken:

Hippocratic Oath

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not”, nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Chiropractic Oath:

I do hereby swear before God and these assembled witnesses, both corporeal and spiritual, that I will do my utmost to keep this, my sacred, trusted oath, as a graduate of the (National University of Health Sciences), that henceforth: I will esteem those who have taught me this Art, Science and Philosophy of Chiropractic and with this torch of knowledge, fashioned by Hippocrates, I will light the way to the understanding of those Natural Laws which preserve the human body as a fitting temple for the soul of man.

I will keep the physical, mental and spiritual needs of the sick as my foremost duty, ever searching for and correcting the cause of their disease to the best of my ability, insofar as my science is in the highest precepts of my Alma Mater and harmonious with the Vis Medicatrix Naturae.

I will at all times stand ready to serve my fellow man, without distinction of race, creed or colour, in my lifelong vocation of preventing and alleviating human suffering, wherever it may be found, by exemplifying in my own life a pattern of living in harmony with the Laws of Nature.

I will refrain from any act of wrongdoing and will regard the keeping of a patient’s confidence as a moral obligation, using any such information only in his or her best interests. May God so direct the skillful use of my hands that I may bring strength to the sick, relief to the suffering, peace of mind to the anxious and the inspiration to mankind to attain bountiful health

That we may live this life to the fullest expression of its innate endowments. I therefore, solemnly swear to uphold these principles and precepts to the best of my ability, so help me God.

Most individuals that go into a healthcare field indicate that they would like to help people.  While money is also a driving factor, the initial factor revolves around the ability to see people improve their lives.

We live in a strange era right now because in the United States there are so many different insurances that cover so many different things and there are nuances between companies.  Sometimes we perform the exact same procedures in the office and the reimbursement can range $40 from the low end to the high end and this is just the way the contract is written.

Are there certain policies that pay better than others, of course.  I would be lying to you if I said anything different. Some are easier to work with than others and coding can be different from plan to plan.  Is it a lot of background work, yes it is, but at the end of the day you need to come back to the reason you went into a healthcare field in general, to help people.

A general trend that you have been seeing recently is that offices are starting to drop certain insurances and adding back in cash services. While I completely understand the numbers behind doing this, I feel that ultimately the patient is the one being left behind. Insurance is offered through jobs, Federal marketplace and normally government services. The patient does not normally have a lot of say of the intrinsic details and coverage that the policy covers. Patients are paying for coverage and will normally go to a provider that is in-network. Why pay more for coverage you are already paying for.

The argument is that certain insurances just don’t pay enough to justify accepting the care.  While I would argue the office is not necessarily losing money, it’s just not making “enough.” So they let those long standing patients go somewhere else because their insurance (unless they want to be treated out-of-network or cash) which they probably didn’t get to choose, does not reimburse enough.

(I’m not going to get into the argument of insurance companies cutting reimbursement rates while operating expenses continue to go up, premiums go up & reimbursements go down, this is an entirely different argument)

The ultimate discussion is that people need care and while money is a huge driver in healthcare, it should not be the ultimate driver. Taking care of people of all walks of life is the oath that was taken and will continue to be followed.  We accept nearly every insurance plan offered, will take auto cases, work comp cases and cash patients. We charge a fair price for the services that we provide and are honest to a fault.

I would implore my colleagues and fellow healthcare professionals to think back to the day you took whatever oath you took and the excitement/joy that came with that day.  Bring that energy back to the office and help the people that are seeking your care, trust me the money will follow and you will lead a great life.