The Ideal Neurology Clinic Blog

Dr. Chalfin will be out of the office from Thursday, December 19, 2019 through Monday, December 30, 2019 while she helps a hospital in Wisconsin with their neurology coverage. Please feel free to leave a message on her voicemail if you need her, as she will be checking in regularly. Happy Holidays!!

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This post is a controversial one, I know. As a patient and consumer, I don't like giving out my credit card information any more than the next person. As a physician and a practice owner though, the time has come and gone to make this change.

Here's an excerpt from an article about doctor's offices keeping credit cards on file that I think sums up the issue quite well:

Speaking on behalf of the AMA, Robert Mills said in an email: "Employers are offering health plans that require their employees to shoulder a greater share of health care costs. Total cost-sharing for the average patient from deductibles, co-payments and coinsurance has increased from $422 to $747 between 2004 and 2014, according to the Kaiser Family Foundation."
He said the cost-sharing trend is accelerating because of the health insurance exchanges opening up. Those often come with high-deductible plan options that people choose to keep their premiums down.
Meanwhile, overhead for doctors' offices has soared, he said, in part because of time spent complying with government regulations and health insurer policies.
"To lower overhead costs," Mills said, "medical practices are focusing more on streamlining patient payment collections. Some practices do take credit card numbers for this purpose."

Basically, insurance companies do what they can to squeeze money out of good people and good practices. And unfortunately, to stay afloat, those practices cannot afford to write off the patient's responsibility - what's more, it's illegal not to collect the patient's responsibility if we have a contract with an insurance company. For those of us "micropractices" who don't have a lot of staff or resources to send statements and call patients to harass them about payments, keeping a credit card on file is a much more convenient and hassle-free way to collect those payments. It is our policy to keep those CCs on file with a secure third-party (we use Stripe). We only use it to charge for copays, deductibles, coinsurance, late cancellation fees (so please do call us or cancel/reschedule your appointments at least 2 days in advance!), and any non-covered costs. Usually it is charged at the time of your visit, and we give you a heads-up before your appointment how much the charges will be (or a range), and if it's a charge that comes up after we receive your insurance statement, we will do you the courtesy of calling to let you know first and ask if you'd prefer to pay using another method. Despite these practices, I understand that not everyone will feel comfortable with this policy. My practice is small, and it won't be for everyone, but that's okay - I have to keep the lights on in order to help anyone at all.

Want to learn more about the issue and why more doctors are ditching their insurance contracts altogether and moving to direct-pay practices? I love this EXCELLENT analogy: How Do Doctors Get Paid?

Have questions? Please feel free to comment below or send anonymous feedback here.

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I recently completed an online course I now recommend readily to all my family and friends: The Yale Science of Well-Being course on Coursera (free!). It's self-paced, with both short videos and suggested readings as well as mini-quizzes to test your comprehension. It talks about, well, the science of well-being. It answers these questions: What is it that we want? What is it that we maybe don't want but should want because it will make us happier than the things we do want? How do we counteract our natural instincts to want the things we should not want? What can we do to really increase our happiness? How do we build healthy habits? I really enjoyed taking it, and I think anyone who has ever wanted to make a change in their life would enjoy it and benefit from it.

One of the things I learned from this course is "WOOP"ing. WOOPing is a practice/method to put your wishes into action. It stands for Wish, Outcome, Obstacles, and Plan, and it's backed by 20 years of research (you know how long it takes research findings to reach the mainstream...). It incorporates some of the things we love about positive psychology, as well as the benefit of pessimistic realists who are always looking for what will go wrong! Try it out. I've already seen its benefits, so I will recommend it to you here as well! You can do it yourself, online (, or on the mobile app (link on the website).

I do not get any kickback or benefit from recommending both of these to you :) Just the benefit of feeling like I'm helping another human. If you try them out, let me know how it goes!

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