Docs who drop insurance take on big business risks

Like many physicians who switched to cash practice, brothers Jonathan Izbicki, D.O. and Harry Izbicki, D.O., experience a rosy view of life without insurance hassles, U.S. News & World Report reported.

"I get home by 5 or 5:30 at the latest," Jon Izbicki, owner of Izbicki Family Medicine in Erie, Pa., said. "My paperwork is complete. I leave smiling, I'm happy, I'm not grumpy and irritable. My life has gotten a lot better. I feel like a professional, that I'm doing what I signed up for."

In addition to shorter hours, doctors who open fee-based practices can save tens of thousands of dollars that they'd previously spent on insurance billing, purchase medications and order lab-work at bulk prices, and gain more time to focus on patient care, according to the article.

But leaving traditional practice, as FiercePracticeManagement previously reported, carries substantial financial risk because being dependent on revenue from a small self-pay panel makes practices more vulnerable to losing large percentages of income.

For Aly Cohen, M.D., an internist and rheumatologist in Monroe Township, N.J., who plans to switch to a retainer model July 1, the stakes are high, as about 70 percent of her current patient panel relies on Medicare. Not only does she have to ensure her new practice draws enough business from other patients, she told the publication, she won't be able to re-enroll in Medicare for two years after leaving.

The Izbickis are equally dependent on success, having "leveraged everything [they] owned" to open their retainer practice in April 2010. "The humbling reality is that if this conversion to direct primary care practice failed, we would lose everything," Jon Izbicki told the magazine. "It would be hard to justify such a risk if things were so great in primary care, so when the going gets tough the tough gets going."

To learn more:
- read the article