Managed Care


A Tale of Two Doctors

A Tale of Two Doctors

Steven Peskin, MD

A close friend of ours went with my wife to see a highly regarded physician for a persistent problem. This master clinician started with a warm greeting and a brief conversation about family, and then went through a detailed history of the problem that our friend had experienced for several months. He gave her an explanation of what he believed to be the underlying cause of her symptoms, gave a prescription for lab tests, and prescribed two medications. He also suggested that she see an ENT and recommended someone.

Our friend’s father had already recommended an ENT. The father, who happens to be a physician, had seen this ENT as patient.

 The contrast was stark. The physician was curt, made no effort to establish rapport, made a passing negative comment about the other physician’s medication selection without suggesting an alternative or the rationale for his disagreement, performed a 5-minute procedure of visualizing the inside of the nose (nasocopy), and, in closing, said “How do you breathe through that thing?? You should have it fixed.”

He charged $625.00 for the 5-minute procedure and $225.00 for the office visit.

The first physician followed up by phone, showed concern, and made recommendations about where our friend could follow-up within her health plan network.

Our friend, Doctor Smith (his real name), consistently shows genuine human interest, brings to bear keen diagnostic acumen, answers questions, and coordinates care. He has practiced this way for many years with patients from the C-suite and from homeless shelters. In sharp contrast is Dr. Rude, not his real name, who, sadly, gives our profession a black eye. Let’s reward and value the Doctor Smiths and devalue the Dr. Rudes.  Our provider networks, payment system, and, consumer information should align accordingly.

Steven R. Peskin, MD, MBA, FACP, is associate clinical professor of medicine at the University of Medicine and Dentistry of New Jersey — Robert Wood Johnson Medical School.


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015