I had a conversation today with a fellow breast surgeon who shared that the large company she works for has decided they will no longer bill for preoperative counseling visits. I want you to sit with that for a moment. They’re no longer billing for the visit where a... patient learns what to expect from surgery, where her incisions will be, what recovery might look like. Where she gets to ask questions, be heard, and feel truly prepared. To the company, it’s not “valuable.” But to the patient—and to her doctor—it absolutely is. When companies and insurance providers decide what matters in medicine, we risk losing the most human, most important parts of care. If we don’t protect these one-on-one visits, if we don’t call them what they are: essential, we will lose them. Let’s not wait until it’s too late.show more

Agree. These visits are so important. The most important question patients ask is silent: "Do I trust this person with my health or not."

Thank you for continuing to speak out for patients. As a uterine cancer survivor I know how important these pre op appointments are because it was very important to me. I was able to get all of my questions answered before my hysterectomy including discussing keeping my ovaries. It is an essential part of the preparation and ensuring informed consent. That is just outrageous.

Some offices fire patients over these denials. One office manager told me recently, "We just don't have the time or staff for this now." Thank you for fighting and speaking out.

When is one supposed to go over all the risks and benefits and informed consent, etc.? That is just supposed to be done for free? Let’s tell lawyers that every millisecond of their time cannot be billed anymore, and that it should be done for free.

Doctors who work for these big corporations- hospital systems no longer have any leverage or say in these matters. What happens with them sets the standards for private practitioners. This is by design It forces the patients to go to the doctors on their lists and that’s usually the hospital owned doctors . It’s an ugly business It has nothing to do with what’s right for patient care What leverage do independent practioners have?

It is a blow to informed consent.

It’s valuable because it is how you create informed consent. Shame on the healthcare company for not allowing that time to be billed.

Probably an rvu based MD comp model and the system loses money on that part. So they write contract with MD to only pay work for billable items or expect most mds won't catch the dropped rvus. Nearly guaranteed to be something along those lines.

Heard once from someone in training: “Physicians are Eagles gaslit that they are Chickens” I’ve never been so happy to have made the jump to Direct Primary Care and eject from the madness of arguing with health insurance corporations that patient premium money should go towards paying for actual medical care that would benefit them. It’s like screaming at a charging Polar Bear….you don’t even stand of chance, just run.

So basically they want her to work for free? “Slave consults” Yea, I wouldn’t accept that at all. If the company doesn’t want to bill, fine. But you should still get paid for it.