Practitioner Question of the Month – February 2018

Reggie asks, “How do you deal with patients who are unwilling to spend money on testing? I understand you help patients not to pay too much, but what about on the other end of the spectrum?”

Great question Reggie. Let’s take a step back since the cause of this problem is likely to begin further upstream and occurs in your intake process. To put it somewhat crudely there are two extremes that every clinician must balance;

• Extreme one: higher barrier to entry
  • Higher appointment cost, less insurance use, longer paperwork to be filled out
• Extreme two: low barrier to entry
  • Lower appointment cost, more insurance use, shorter paperwork to be filled out

What does this mean and why does this matter? It matters because each one of these manifests in certain pros/cons for the patient population you will attract.

• Extreme one: higher barrier to entry
  • Pro: highly motivated patient, more compliant, less cost averse
  • Con: patients are often more challenging to work with and more difficult to produce clinical response in
• Extreme two: low barrier to entry
  • Pro: patients are easier to obtain clinical response in and are easier to work with (if you make reasonable recommendations)
  • Con: patients are often less willing to spend money and can be less compliant

So, to your question, the problem might be that your barrier to entry is too low.

Also, if you work to make the minimal recommendation with a patient like this you may find a reasonable compromise. For example, they will do a SIBO test or a stool test, but not both. So have a dialogue and see if you can find a reasonable compromise. It’s important to meet patients where they are. Often times if you start small with a patient like this and earn their trust through producing results, they will be open to more in the future. Go slow and steady. Be patient and supportive. Help them however you can and don’t get wrapped up in what you would ideally like to do.

And finally, to paint an alternative perspective, these patients can also provide a good opportunity to hone your empiric treatment skills. So, don’t overly fret over their unwillingness to perform testing.

Is Your Cloud HIPAA Compliant?

It can be challenging to balance being digitally progressive and being HIPAA compliant. In many cases, it seems the digital technology is outpacing the ability of these offering to maintain HIPAA compliance. Fortunately, Dropbox now offers HIPAA compliance via a few minor systems and settings changes. If you are keeping any files related to patient care in Dropbox you should consider making the update to be compliant.

I’d like to hear your thoughts or questions regarding any of the above information. Please leave comments or questions below – it might become our next practitioner question of the month.