Every November rolls around and most people in healthcare just buckle up and try to enjoy the ride. People meet deductibles and need to use FSA and HSA funds before the calendar turns over. Patients that you have not seen in months all of a sudden need care because they had a surgery or a procedure earlier in the year and want to utilize their insurance benefits.

Every year we tell ourselves that this year is going to be different and I would be lying to you and myself if I said it doesn’t seem to get better or easier.

Obviously, when you own a business being busy is better than sitting around and twiddling your thumbs. People in the door are what pay the bills. While healthcare is kind of complicated to explain to lay people that don’t quite understand the reimbursement process or how insurance works, the bottom line is that you need people to come in the door to pay the bills.

I have said for years that the first half of the year, you just try to keep you head above water as patients are trying to figure out new insurance and the timing of when I started the business, all of the yearly bills are due during the first half of the year.

The buffer that a business like myself has is that being diversified is what carries you through.  While I have always said that I believe in staying in my lane having numerous different services is ideal in my world. Acupuncture always needs to be done and people are always in pain and need of chiropractic care. The DOT side is an interesting thing in our business as it is a service that is needed year round.

As stated earlier, I have certain times of the year that the DOT/CDL services are busier than other but as this service continues to grow; the ups and downs seem to be leveling out. Adding the drug & alcohol testing is an added benefit for most of the drivers that come in for DOT physicals but this is not a seasonal service, it will be year round as well.

The reason that I write this is to remind myself and patients that come through the doors is to have patience. Every year, we tell ourselves that we are going to schedule better or that we need to be more lenient with people and every year we end up in the situation. Everyone’s lives are hectic and chaotic this time of year but a little bit of patience and reflection as to why we are doing what we are doing along with ultimately everything will be okay with the schedule and the office.

As the years go, services are stabilizing with things that I like, prefer and make most sense for the offices but there are things that do take more time than others so if you come in and we are running 5 minutes behind, just know that we will take our time with you as well and I will get back on schedule but this time of year it can be difficult due to the pure volume of things going on.

We continue to strive to offer the best service possible for chiropractic care, DOT/CDL physicals, acupuncture and drug/alcohol testing. Services are not going to change in my opinion for the foreseeable future but we continue to get busier and busier with all of the services, so we ask for your patience and continue to appreciate your patronage.


October 2012 is when I first passed my FMCSA medical examiners test.  This test allowed me to perform DOT/CDL physicals. The first couple months, I did maybe 1-2 physicals per month.  The first couple of years I did maybe, 4-5 a month.  The time period that it took allowed me to become comfortable with the process, the exam itself and the reporting process.  In 2013, the Department of Transportation required that you pass its testing requirements.  Come to find out at the time, I was one of the few people in the state that was ahead of the requirement.  This was honestly not my intention but it turned out to be a reality I was living. We have recently just passed another 10 year recertification.

Fast forward nearly a decade, I’m not going to divulge the number of physicals that I perform on a daily, weekly or monthly basis but it can be said that I found a market that I am very comfortable in, know the regulations and have a solid understanding of the process for the drivers that come in. We field questions daily on the process and from all walks of the profession of how to abide by the rules, keep compliant with regulations and keep driving going with minimal interruption.

There are people that return to our office every year or two for this exam, not because they want to because they have too.  The FMCSA requires drivers to get periodic physicals and to maintain an active medical card.  We have people that I have seen 7-8 times at this stage and look forward to continuing that relationship and trend for the years to come.

I’m reiterating this fact because recently we have found that most companies are looking for a one stop shop for all of their DOT needs. Part of that need is for drug and alcohol testing. These are fairly straightforward parts of the process but there are certain criteria’s that needs to be met in order to accomplish this task. We have met those requirements.

A couple of months ago we made the conscious decision to go all in on the profession as a whole. Chiropractic and acupuncture will continue to be the main focus of the practice but you will continue to see a push to engage companies and professionals that need a drug testing program for the work place or just need to be a part of a consortium for the FMCSA in order comply with DOT regulations.

We have purchased the equipment and have the expertise in order to perform these services. Over the course of the next few months to years, we hope to expand and be the go to office for all of the needs for DOT and drug testing needs.  Mobile services will soon be available as well as we work through the needs of individual companies. Convenience is going to be the motto as finding reliable testing in the area can be tough.

The goal and mission of this service is to start small, with local companies to gather a vast understanding as to the needs of the community as a whole and growing from there. Envisioning the growth will be much like the DOT physicals that we have performed, doing a few on a weekly or monthly basis until we are very comfortable with the process until it becomes almost second nature for myself and the office staff that will be helping with the systems that are set in place.

Finding the processes that work for the offices is the easy part, it’s the execution that can become difficult. We look forward to running a very efficient FMCSA compliant office in regards to DOT physicals, drug testing and breath alcohol testing that people feel comfortable with the process and that their paperwork will be ready, willing and compliant. If this is a process that you would like to join on the ride with us please reach out to us, as many renewals are coming at the end of year and would love for us to take care of your DOT needs.


When I say” come one, come all” I genuinely mean that. We get patients periodically that will say that they are no longer allowed to go back to their original chiropractor because they missed an appointment. They don’t have the correct insurance to see a specific chiropractor. The excuses are endless and 12 years into practice we have essentially heard them all, but I write this more as a promise and reminder to myself.

When I went into a healthcare field, I told myself that we were going to be a welcoming office for all walks of life, regardless of insurance types or how needy the patient can be. I took an oath when I went to school for this and I will continue to strive to make this my moral compass.

“Take care of your patients and your patients will take care of you.”

I’ve said this before, a lot of people don’t necessarily have a say as to what kind of insurance they have or certain life circumstances that happen. Life can come at you fast, appointments are forgotten but I don’t feel that should be a reason to never be welcomed back into an office again.  We accept nearly every insurance that is offered in the state of Nebraska, including Medicare and Medicaid.

We have treated people in half-way houses, just getting out of prison, down on their luck, looking/searching for a job or career choice. Broken down vehicles and family situations arise and we totally understand this in the office. We accept walk-ins with the understanding that scheduled appointments will take president, but you are always welcome.

If I told you there was a limit as to what I would treat, I would once again be lying to you. We treat young and old alike, but we stick to a game plan with musculoskeletal conditions. If an internal discussion needs to be had, we can have it but the odds of me actively treating such conditions would be slim. I can guide people through options and certain providers but chiropractic treatment for diabetes is a little out of my realm, as it should be for the entire profession. I know my lane.

I have done this long enough to know my limits and what I am comfortable with. We may treat a little different than some providers and we are known to keep things simple from the start and build from a solid base. We won’t jump to options that we don’t think will fit a patient.

Acupuncture is a prime example, we have performed more acupuncture in the last year than I did in the first decade of practice combined. Some really cool results have followed but this is not a therapy for everyone, you need to fit a specific demographic or complaint. We don’t delve into smoking cessation or weight loss with this as some offices do, but I can promise you that if you give it an open minded try, you might be surprised.

Truck drivers and CDL drivers come in all shapes and sizes, we follow the FMCSA rules and won’t be sweet talked into a decision. Smelly and good looking truck drivers come under the same scrutiny but just know both are always welcome in our offices.

As I said earlier, this is more a reminder to myself to be a genuine human being, treat people how you would like to be treated and know that no matter what you are going through you will always be welcome in our offices.


Find something you love to do and you will never work a day in your life. This old adage has been around forever but does it ring true to you? If you are one of those few people that “love” what you do, I would like to have a talk with you.

I have reached a stage in my life where balancing ailing parents, raising young kids, having a stable home life all while running a successful office starts to become a grind on a daily basis. If I told you I was alone with this sentiment, I would lying to you. Everyone has passions and interests, but passions and interests don’t pay the bills. Anytime I can get a day or a few hours off, I take them because taking time out of the office is few and far between.

It may not seem like I am in the offices much, but when you balance two offices, family and staff, things get stretched pretty thin at times. So, if you call the office and we are not in that particular office, it does not mean that I’m out playing golf or enjoying myself, I’m just at another office, so while it seems like a day off to the person calling, we are actually working.

I’ve been in business for over 11 years now and we have learned to brush off a lot of the snarky comments that people lay on us throughout the day. I’m not saying anything that the people that read this blog, but our practice is the ultimate example of the 80/20 rule. The rule basically says that: 80 percent of the problems in the practice (or life for that matter) are caused by 20 percent of the people that walk through the door.

If I could handpick the people that walk through the door and not treat the people that cause the majority of issues it would be a lot less stressful and eventful, but what fun would that be. I have this discussion all the time with the people in my life, we will treat nearly everyone that walks in the door because it is the right thing to do and as a health care provider, you make an oath to help people to the best of your ability.

Part of being an adult is getting up in the morning and showing up, I was taught when I was young that half the battle in life is just showing up. If you show up, the odds of you putting forward some sort of effort is pretty good, so just keep showing up.

By showing up, you are signing up for the grind, life is a grind, I don’t care what anyone else says, there are certain things in you life that you don’t want to do but as a responsible human being you do what needs to be done. Finding enjoyment in this process, is ever elusive but always being sought. I look at the schedule every day and determine, where else would I rather be right now (lots of places, but an adult keeps showing up to work), I get to be my own boss, help people with lots of issues and problems, there are not a lot of people that can say that.

While showing up to work on a daily basis is a grind, I am finding enjoyment is seeing numerous people with different life stories and adventures. Getting to know people on a personal is fun for me and the broad topics that are talked about and discussed in the office is interesting. Not everyone can say that they enjoy their job, I do.

Find enjoyment in what you do, keep doing it and just know that you are not alone in the grind but the small things do make coming to work and helping people well worth it….Just Keep Going.


The world is a wild place anymore.  Every day we walk into our jobs and try to find some sort of enjoyment out of it. I really do like and enjoy my job and the business but this topic has come up a few times in the past couple of weeks in our house. Your job does not identify who you are as a person.

Outside of the office, I would like to think that I have a family life with my wife and boys and attempt to have a social life by playing a little golf and potentially getting involved in other organizations within my interest level.  The office is a lot of who I am as a person and I get to run it the way I want to run it but as my boys get older, I’m going to make a conscious effort to make sure that it does not deter me from being a part of things that are larger than the office.

One of the main reasons that I went into the profession, is that I knew I would be able to call my own shots.  If I need to be out of the office for one reason or another, I don’t really have to explain myself to anyone.  Most of the time, things are not so urgent around the office that life has to stop and the office needs to own my time.

We don’t wait around for walk-ins at the end of the day or around lunch for that matter.  If we have nothing scheduled I have told myself that my life goes on outside of the office and if nothing is scheduled at the end of the day, I’m going to get out of the office if I can.

I went to school with plenty of people that are no longer in the profession for whatever reason and for that matter it doesn’t matter.  Lots of people go into student loan debt and get degrees and use them for a few years and then figure out that this career is not for them (I would argue that chiropractic is a terrible return on your investment in regards to student loans) but this does not necessarily ring true for everyone.  If you are not happy or at least content with your situation, odds are there is probably a better situation out there.

Just because you went to nursing school does not mean you have to be a nurse, law school does not mean you have to be a lawyer and becoming an engineer is not a lifetime sentence if you don’t want it to be. There are always alternative options in nearly every profession so if you are unhappy with your situation; make something happen and start asking around because odds are you can change your scenario.

I’m adding a few more services to the office in the coming weeks not because I don’t like what I do but because I feel that we can add more value for people that walk through our doors.  Is it an exit plan, I don’t think so but if things go how I hope it does the prospect of more people and more services with the ability to give me more flexibility and freedom is a possibility.

In ending, the fact of the matter is, is that if you are not content with where you are in life or your profession, look around and start asking.  If you went into chiropractic and don’t like adjusting people, there are very profitable avenues to use your degree that don’t involve the traditional chiropractic practice. Just because you spent the money to go to school does not lock you into the profession in the traditional sense.  Lawyers run non-profits, chiropractors can work for insurance companies and medical school graduates can work in finance. It’s possible and realistic that the world changes quickly and you are more than welcome to change with it or stay stuck in the past, the future is up to you.


Over the course of the last 10 years we have performed DOT/CDL physicals for all types of drivers.  From bus drivers, farmers and over-the-road truckers, we have seen just about every walk of life come through the office for this service. I just renewed my 10 year certification a few months ago and it hasn’t seemed to have slowed down, in fact the service keeps picking up year over year.

We have a vast knowledge of the industry, so we have decided to add a few services that come along with the physical itself.  Over the course of the next few weeks, we are going to be implementing drug testing and breathe alcohol testing, this will be mainly targeted at the trucking industry but we have a vision of possibly branching out into other industries and being mobile.  We will start slow and build from there, just like we have with DOT physicals.

The need for these services is needed in the area and we plan to try to meet the need of so many companies and individuals that are in need of fast, reliable service.  Kristina is planning on helping with this endeavor. The goal is to have an office that is all encompassing, where workers and drivers can come and receive everything in a one-stop shop. As opposed to running all over town to accomplish different things that just takes time out of the day.

Fast, professional, efficient will be the name of the game that will be run and overseen by healthcare professionals in an environment that is welcoming and knowledgeable. We have already gotten set up with our own network lab for collections, CLIA waivers have been received and we are just waiting on a few pieces of equipment to come in.

We understand that a lot of companies have locked into current contracts, if you are one of those companies, we would still love to hear from you as we would love to become your collection site. The next 4-6 months will tell us a lot, as we will more than likely be setting up our own consortiums, in order to have our office and staff just manage small companies drug and alcohol testing that will be compliant with the current standards that are required by the Department of Transportation.

I’m going to lay out a vision as to how this whole process will go, over the course of the next month we get everything up and going, we become a collection site for the drivers that we already see come through our offices. We then start the consortium route, where a few local companies let us just manage their services, from the basic DOT physical to all of the regulated drug and alcohol testing that is required. We also hope to have the ability to go onsite to perform pre-employment drug testing and random testing for non-DOT facilities in the area.  Post-accident and return to work will also be done in the office as well.

This process is not rocket science and we look forward to being a site that continues to be trusted to take care of a profession that is often over looked. If this is a service or you or your company just has questions about how the process goes, please don’t hesitate to reach out as we would love to talk about the needs of community at large.

As stated earlier, if you are looking for a welcoming, all encompassing office to take care of your DOT physical, urine drug testing and breath alcohol testing all in one site that is overseen by healthcare professionals that are knowledgeable about the industry and have lots of local information about the drivers that already present to the office, please reach out to see how we can help with this required service from the Department of Transportation.


I’m going to go on a little bit of an explanation or rant as some would call it based on a few phone calls that we have gotten recently. It never fails that about 10 days after we bill we begin to get phone calls explaining that they don’t owe us money, their insurance should have paid for the service. Don’t get me wrong, I want your bill to be as low as possible but we are obligated to bill what we do, run a business that actually pays its bills and to follow the contract that is laid out by the insurance company that we agreed too.

We obviously have preferences when it come to certain insurances, as some process quicker and are more efficient but we are not naïve enough to say that we won’t take certain insurances, at this point. Most individuals don’t get to pick what insurance their employer picks for them and if you choose off the Marketplace, cost and coverage are a huge factor.

I read an article a couple days ago indicating that the University of Nebraska is moving back to Blue Cross/Blue Shield.  This is great news for most providers as it is one of the few companies that is efficient and easy to work with.  Not that other companies are difficult as most things are done electronically, BCBS just seems to process quickly and without much headache.

Certain insurances cover certain services while other don’t cover other procedures, bundled services are a thing.  When we bill one CPT code (what we do) some other CPT codes may not be covered as the insurance company considers them to be bundled and don’t reimburse for more than one thing on one particular visit.  If this seems confusing to you, it is even as the doctor and staff that try to keep up with it on a daily basis.

I’m going to give an example: we are in-network with Medicare, when a new Medicare patient comes in we know that the initial exam and therapies are not covered under the plan, we explain this to people and have people sign an ABN indicating that you as the patient understand that certain services are “non-covered services.” We don’t do this because we like to, we do it because we have to. The rules are the rules with certain companies and when we sign up with them, we agree to follow the rules.

I’m not all that interested in receiving phone calls from patients telling me that I will be getting a phone call from their insurance agent and that they are disappointed in me for the bill that they received. The staff hates taking the phone calls and honestly, there is not a lot to do about it. We do initial exams on EVERY new patient, it would be irresponsible not to, we need to cover our basis as well.

If you are unhappy with your insurance coverage, take it up with Congress if you have Medicare, the State Legislature if you have Medicaid, your HR department for your employer based care or pick a different plan on the Marketplace.  We aren’t sending out bills due to spite and if you are refusing to pay the bill and threaten the office because of a bill, I will gladly give you a referral to another office that will bill you the exact same way if not worse.

This is not intended to be a mean post, but it gets very frustrating explaining insurance to people that have no idea what they actually have and then get mad at us when we are just doing our job. We sign contracts with companies not because it’s fun but because patients want to go to providers that are in-network with their coverage and possibly have things paid for based on how the plan is written.


May 1st marks 10 years of business for Spracklin Chiropractic. The middle of April was 11 years after graduation, has everything been sunshine and rainbows?  I’d be lying to you if I told you it was. This past year has actually probably been one of the more difficult ones, not necessarily from a practice prospective more so from a family prospective.  I have had a lot of things going on with my family that keeps my mind wandering, but overall business has been great.

Small business ownership is not for everyone and I’ve had my doubts over the years.  The ups and downs of the finances and the ebbs and flows of practice are tough at times. You will question yourself and doubts arise all the time, but we have for the most part stuck with our original intention.

You’ve got to spend money to make money is the famous saying, while there is some truth to this, as a business it really sucks.  The locations that we are in have been awesome up to this point (minus the bats that we continue to find in the Minden office) but we have decided to do a few improvements to the offices that will be seen in the weeks to come, it is fun to spend this kind of money, not really but with small business ownership, you either have to spend some money to improve the business or pay it in taxes.  So it looks like improvement is the way to go at this stage.

The buildings are perfect for what we need at this point and the current equipment is great for our needs. I’ve always said that my goal is to have offices that are mirror images of each other and we are getting there; there are a few things that I’m on the hunt for in order to accomplish this. From a patient prospective, you probably wouldn’t know the difference but from a practitioner prospective I definitely notice.

We are always looking for new and different opportunities to integrate into the offices but the scope is fairly narrow as to the things that we are open too. DOT physicals work awesome into the offices but if you are looking for anything that involves injections or high pressure sales pitches, you may want to keep looking. We make no apologies for what and who we are, honest to a fault and simple are the way of the offices. Reasonable prices will always be a trademark for the office and we will continue to accept most insurance. We get approached quite a bit about different sale tactics and therapies but find it almost impossible to say yes to certain things because they don’t fit a certain criteria.

Most recently we have been doing a lot of acupuncture. It’s an awesome therapy that does wonders for people but this is not something I push a lot, it can be used for lots of different conditions but if the patient is not willing to try it a few times then it’s not worth exploring.  You have to give it a fair shot to work and most people in my office are not willing to give up the time and money so we try other things first.

Practices and people come and go from the area.  We would like to think that we will be around for many years to come, treating patients in an honest and ethical way will continue. There is always a new therapy or sale pitch (we’ve tried a few and while not necessarily a flop, keeping it simple is usually the easiest and best way). Attitude and mindset play a big factor in practice development and we try to bring a positive, fun spirit to the office daily but just know that everyone has a story and if that spirit is a little down on a given day, give a little grace.

With all this being said, we appreciate your patronage over the years and look forward for the years to come.  Growth is the goal but sometimes holding the status quo is the best you can do for the moment and that is okay. Be kind to people in the world and bring smiles to those around you.


This past couple of weeks have been kind of a reminder of what exactly we do while being in practice. We try to make things as easy as we can when you come into our office. I’m going to go into a few examples that we have had this week and then elaborate on them at the end:

  1. Someone calls the office and indicates that they would like acupuncture. She stresses multiple times that all she wants is acupuncture and nothing else. We agreed to this. Paperwork gets filled out, I have a brief conversation with her to make sure that we are on the same page as to the expectations of the visit. We perform the acupuncture, she gets off the table, happy as a lark, thanks me profusely, walks to the front desk, writes a check and schedules for more care all with absolutely no push or convincing from me. Seems like a pretty simple thing if you ask me, but this seems to be a rarity in the market.
  2. Patient has been shopping around for chiropractors. We have seen him before, but he wanted to try something different.  He wasn’t necessarily unhappy with care but wanted to try a different approach (This actually happens all the time, so don’t take offense if you are a new chiropractor if someone leaves your office for a while and then comes back). Right side lower back and hip pain is the main complaint. He works on a farm and is on concrete and under equipment most of the days. He doesn’t want to pay more than he has to and he wants to get better in one visit. Laugh all you want but this is normal.  We do what we do, treat him the best that we can and he gets a little relief. Before he leaves he says he will be back next week, this is not on my urging. He’s happy and thanks us for taking the time to listen to his issues.
  3. Last example, long time patient comes in with left shoulder and scapula pain. We treat him roughly 3-4 times, no red flags are noted that would indicate advanced imaging or anything beyond what we can provide in our office. He doesn’t feel that he is making enough headway with care so we end up sending him to his primary care doctor for a second opinion. He returns a week later indicating that his primary care would like him to continue care with us, they indicated that proper treatment was being rendered and that give it a little more time and we would eventually get it solved.

I use these specific examples for a reason. When someone calls the office and requests a specific service, why as a profession do we feel the need to push other services. While I completely understand that I have numerous tools at my disposal but if the patient is not happy when they leave the office, you essentially are losing a patient. At a certain point, it’s a mind game. A happy patient will return for more services and refer their friends.

Patients will come and go and we have our own bias built in but just know that most of the basic treatment provided by chiropractors is largely unchanged on a simplistic level. Techniques may be slightly different but the overall goal is the same, but active listening and taking a genuine interest in the care shows that you do care. For the patient we hadn’t seen in some time we did nothing different than any other office we showed a listening ear and a productive service and he left happy.

The third patient is actually the most interesting to me because he indicated that his primary care physician had nothing but positive things to say about our office and treatments. I do not know them on a personal or even professional manner. I find it actually flattering. We treat people for what they come into the office, we don’t try to up sell services that are not necessary and treatment plans can be few and far between. When trying to work with other professionals knowing what your limits and expertise is can be very beneficial.

In ending, treat people with options that they actually want, active listening is probably more beneficial than the treatment itself, keeping things simple can prove to be just as beneficial as thousand dollar treatment plans and staying in your lane with other healthcare professionals are some of the keys to success of our practice.


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.


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