Even at New York-Presbyterian Hospital, a tertiary care center with built-in referral sources to the ENT department, patients are struggling with financial uncertainty. “Even patients with jobs are more cautious. We’ve had patients put off elective surgery because they don’t want to make waves at work by being absent,” Dr. Stewart said.
The plight of some of Dr. Datta’s patients at South Nassau Communities Hospital seems even more dire. “To have honest, middle class people who always paid their bills cancelling appointments and cancer surgery breaks my heart,” he said. Despite Dr. Datta’s willingness to waive his fees for those patients, hospital and other professional fees remain. “Even though the hospital has funds for indigent care and our social workers try to obtain emergency Medicaid cards and other funds, some patients are so stressed about money that they won’t focus on their urgent health care needs,” he said.
—Marc Lion, CPA, CFP
Despite the recession’s toll, doctors are taking steps to keep their practices afloat. Dr. Friedman, having seen hard times coming several years before the downturn, repositioned his practice for growth. “I looked at our practice and reimbursement rates and knew we’d lose the volume of surgeries in a slowdown. We combated that with a plan for significant growth by doubling our space and adding another physician and in-house CT scanning. We also changed the style of our practice by giving appointments promptly rather than having patients wait.” Overall, the strategy has worked; surgery volume is down but billing is up, both from ‘bread and butter’ otolaryngology services and additional revenues generated by the new doctor, Dr. Friedman said.