Yes, the doctors' fees are inflated. By the way, if you came to my office, I would have given you a prescription for the boot because insurance companies will not pay anything - not a single dime - for it. This is something your doctor gave you for free and paid for it himself, and here you are complaining about it! My fees are similar. The reason is the Insurance companies. My most onerous contract says that they will pay 120% of the Medicare fee schedule from 4 years ago (all insurance contracts are based on Medicare fees) -OR- they will pay one third of the bill, whichever is less. That means that I have to charge 360% (more than 3 times) what the Medicare fee schedule is in order to get the maximum fee from this insurance. So that is the basis of my fee. I NEVER get paid this, and I don't expect to. I have a self-pay fee rate that is much lower than my overall charge. But patients ask me all the time why my fee is so high. Now you know.
Your problem is called Somatization. It used to be called Psychosomatic. This is physical (very real, by the way) symptoms that are caused by anxiety or depression. The reason you were dropped is because patients with this problem are depressing, frustrating patients to deal with. Doctors get depressed when there is little they can do for their patients, and then they sometimes get angry or frustrated at the patient for making them depressed. The staff also complain because they usually have to take extraordinary measures to answer calls, reschedule appointments, etc. Patients like this take an unusual amount of time in the office also because it is difficult to convince the patient that their emotions are causing their physical symptoms. This is why your physician dropped you. I am not defending her, but I am actually surprised your doctor continued seeing you as long as she did. All doctors like to see patients that we can make better. That is what we went to school for, after all.
I addressed this in an earlier comment, but I want to reiterate, doctors did not choose or design this system, and we don't like it. The government designed this system, and the insurance companies followed it. To answer your question, if you go to your doctor for a physical, that means they are looking for nothing to be wrong with you. If you complain about ANYTHING, that is called an ACUTE COMPLAINT, and gets an extra charge. The idea (set up by the government) is that if you had something wrong (i.e. the acute complaint), you should have seen your doctor about it before your physical exam, not to wait until you have a physical. And yes, the Medicare system, and most insurance companies have followed, want you to go for a physical when you have nothing to complain about just to get screenings, and do not want you to wait until you go to the doctor for a physical exam to address a problem. Often they will not pay for something extra at the physical exam and want you to be scheduled for a different time. I will address small concerns (as in this article) without putting in a charge for it, but if there is a major new complaint, I reschedule the physical exam and address the acute complaint. What you are calling the "right way" is actually according to Medicare and your insurance company the wrong way. If you don't like the way it is, PLEASE call your congressional representative and have this broken system fixed, and stop blaming your doctor for something he can't control. Many doctors have stopped, and about 40% of doctors (including me) are considering doing away with accepting insurance altogether because we hate being blamed for and having to deal with exactly what you are complaining about. By the way, it costs me about $50,000 per year to collect money from your insurance company, who tries to find all kinds of ways not to pay me for the work I do.
And repeating the things you are saying clouds the picture of health care costs. Doctors cannot charge anything they want. The doctor who charges $100 gets paid exactly the same as the doctor who charges $300 for the same service because insurance companies set the amount the physician gets paid, not the rate the physician charges. You said, "...most insurance companies research the average fee charge[sic] in an area for that service and may only pay for the average fee charged..." You are partially right - ALL insurance companies know EXACTLY what the other physicians in the area get paid because they determine what they get paid! And, it is ALWAYS regulated by the prices that the government sets, because all contracts are based on Medicare reimbursement. I now have a solo practice, but I was employed by a large group before. The CEO who only had an MBA made 3 times what the doctors made. The CEO of the hospital where I see my patients makes 10 times what I make, and he only has an MBA. If I didn't like practicing medicine and taking care of my patients, I would go back to school and make a LOT more money!
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