Editor's Note: the following letter to the editor is addressed to American Specialty Health and is published with permission from the author, who forwarded it to us after sending it to ASH management. It has been edited lightly for basic style / grammar in accordance with the DC style guide.
Dear ASH decision-makers,
I have been an ASH provider, according to your website, since 1988 – that's 34 years! Perhaps I am one of the very longest-running ASH providers.
However, in light of recent skyrocketing inflation, I reflect on the shocking fact that in 34 years the reimbursement rates through ASH from nearly all of your clients (Kaiser, Anthem, Cigna and others) have not increased in actual dollars, and in some cases decreased! $100 in 1988 is worth over $270 today. And yet, for instance, the actual dollar amount reimbursed for HMO clients such as Kaiser remains $27 per visit (perhaps an average of $30/visit when including occasional re-exam payments)!
This is causing great financial pressure and stress on your dedicated providers who are held to a high standard by yo,u but whose personal and business overhead costs have increased by nearly 300 percent since I became a provider.
So, despite your constant messaging of providing great service to your providers and through them to the patients we serve, your increasingly disastrous reimbursement rates are driving us to the brink, and I suspect causing many of your highest-caliber doctors to drop out, thus undermining your mission.
The rates of your PPO clients are nearly universally also no higher than they've been for decades. You are negotiating these contracts and not standing up for your providers. ASH has close to a monopoly on chiropractic managed care, at least here in California. It is time you show us some respect and take immediate steps to correct this untenable situation before more doctors like myself are forced to drop out, to the great dismay of so many of our patients.
Again, please, whoever is reading this, forward this message to the top brass of ASH. And as your loyal provider of 34 years, I deserve a response that does not brush me off by saying your rates are "competitive with today's market rate." That response, which I have heard before, would be wrong, dismissive and disingenuous.
I look forward to hearing from you soon.
Mha Atma S. Khalsa, DC
Los Angeles, Calif.
RE: "The patients Your Practice Doesn't Need"
Editor's Note: the following letter to the editor addresses, among other topics, DC Publisher Don Petersen Jr.'s January 2022 Report of Findings.
Dear Editor:New DCs need to read this piece and take it to heart. Every patient is precious in the early days, and it is hard to show someone the door when chasing the almighty buck every day, but sometimes it must be done. I had no staff for quite a while to get feedback from, and the established practices in my area were not friendly. Now that I am ready to retire and working part-time, I'm concerned about the profession, and who is coming up to take over.
Expanding on the six types of troublesome patients, one patient insisted on calling me by my first name (when we were not friends), and got mad when I tried to inform him that I wanted him to say "Dr. Mark" and stormed out of the office. Once, a patient asked me if a person had to go to school to become a chiropractor! Most of these things I have tried to forget and "go with the flow" unless it got really bad.
Finally, I wish that some docs who have been successful in building wealth would do something for the young guys and gals who are just getting started or even to help them while in school. I would have cherished this assistance. My experience as an associate doctor was just the opposite on more than one occasion.
Mark R. Troyer, DC
Elkhart, ind.
Editor's Note: Comment on an article, address a trending topic, or share your thoughts on any issue relevant to the art, science or philosophy of chiropractic by submitting a short letter to the editor to
. Include your full name, degree(s), and the city and state in which you practice. Submission is acknowledgment that your letter may appear in an upcoming issue, and could be edited lightly for grammar and style guide considerations.