Insurance-Free Medical Practice Rids Office of Bloated Paperwork

Less Than 2 Percent of Primary Care Practices in U.S. Are Cash-Only

By ERIC HORNG
BURNSVILLE, MINN., March 20, 2010

Over the years, Eelkema grew increasingly frustrated with insurance company red tape and meddling. One day, about a year ago, he says insurers began requiring him to change his patients' lifestyles, and that's when he had enough.

"The insurance companies changed their rules from just recommending stopping smoking to the patient actually having to stop smoking and tying my compensation to that," Eelkema said. "I thought this isn't what I went to medical school for."

He charges $36 for one ailment and $54 for two. If a patient has three or more problems, Eelkema recommends a physical, which costs $110. For as little as $90, Eelkema will even make a house call. Prices for his services are listed on his office Web site.

"It's one-on-one, the way it should be, without the third party," Eelkema said.

Less than 2 percent of primary care practices in the U.S. are exclusively cash-only, according to a recent survey conducted by the American Academy of Family Physicians. But it's a growing niche as the number of uninsured and underinsured patients swells.

In a national survey of doctors published last May in the journal Health Affairs, physicians said they spent an average of 43 minutes each workday handling insurance paperwork. That lost time costs practices a combined $31 billion each year, the study concluded, or nearly $65,000 per doctor.

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