Joel Stevens

First, there are two people that got pissed off about this today, and one of them was me. However, I'm trying to parse it out, and I'm going to attempt to present this fairly with some of my own conclusions.

So I had some wax build up in my ear while snowboarding up in snowmass this Christmas. I was desperate to get it out, and spent a lot of the night putting rubbing alcohol in my ear and shaking my head around (does not work). I gave up and went to a doctor on the slope (Dr. Michael Check) to get some relief. While there, I signed some forms and asked him point blank how much it would cost. His response revolved around him not knowing the negotiated rates of my particular insurance (which was true), and did not tell me how much he would attempt to charge. I assumed it couldn't be too bad (foolish), and went on with the appointment. He asked me a few background questions (personal information, any allergies, any previous surgeries) and looked in my ear. He confirmed what I already said was the issue (wax build up with liquid inside), and then blew it out. (He put hydrogen peroxide in my ear and let it sit for 10 minutes, and then used a water syringe to blow out the wax, which was, of course, gross).

So then, I got a summary of insurance for 370 dollars, which my insurance cut down to 240 dollars (woo negotiated rates). The original charge was 90 someodd for "surgery" (apparently it was surgery) and 280 or so for an initial visit. I was pissed. (At this point, I should note that my insurance is very high deductible, so I pay the full amount after the cut off). I thought about it for a while (while waiting for the bill), and concluded that I should pay it and not make a big deal out of it. However, for better or for worse, I got the bill and wrote a letter with the payment (full amount). It said a few things like how I asked for a straight answer and didn't get any, wondered if he thought 370 dollars was an appropriate bill for 20 minutes of work, and threw in an insult equating the "unethical" billing with the problems we have with american medicine and insurance. I did note that I understand he had expenses to pay as well as high rent for an on the slope locale.

Anyway, I thought I was done with it, but he called me at work today (I didn't realize who was calling), and tried to explain it to me. First, he said that the billing amounts were "arbitrary" essentially admitting that he charged a very high amount to get the maximum amount out of insurance. Then some justifications about how much other doctors would cost (e.g., ENT or emergency room doctors), estimating them to be 800 dollars or more, which I responded to by noting I had had this done before for less than 100 dollars. I indicated that he effectively was billing at over 800 dollars an hour which he would not consider an appropriate measurement. I don't recall many of his other arguments, but they all seemed to be revolving around how insurance works and how other doctors charge. He did mention that I might have felt differently about the "simple" (my words) procedure if my ear drum had burst; however, I didn't realize that not being incompetent was a fair excuse for high bills. In any event, after 10 minutes (I was working), I ended the conversation with "however you want to rationalize it", click.

I'm still thinking about this, and I think the main issue is the whole charging as much as you can and see how much you get rather than actually charging how much a service is worth (like a real professional), and the failure to answer my questions about cost. I probably would have still done it for 250 dollars had I known it up front, and I wouldn't have complained later. People should be up front and communicate! I'm open to other opinions if you have any, however.