Stop Mandating That Physicians Pay Unreasonable Fees
Stop Mandating That Physicians Pay Unreasonable Fees
Dear Virginia Birth-Related Neurological Injury Compensation Program,
I received your letter in the mail today, requesting that I pay you a $300 annual fee in order opt out of your mandatory program. You listed the fee to opt in to your program as $6,200. While I’m sure that your program is extremely valuable to its recipients, I do not understand why this financial burden should be placed on physicians and feel that it's inappropriate for you to mandate that all physicians pay for not joining your program. In addition, I simply cannot afford your fees, and I feel that it’s quite unreasonable to assume that every physician has the funds available to pay this fee, or that they should carry this financial burden.
I am a psychiatrist who recently started a practice in Virginia about one year ago. I have since moved my practice to a non-profit organization, in order to help more patients who cannot afford psychiatric treatment. My goal as a psychiatrist and physician has always been and continues to be to provide the highest level of care to each and every one of my patients at the lowest possible cost. As a physician, I had to defer making any income (or barely above minimum wage) for many years in order to pursue medical school and residency. In addition, I currently have approximately $460,000 in student loan debt due to my medical education. I am the sole breadwinner for my family of three. I make a meager income and have such huge student loan payments that I can’t afford many basic things, including being able to afford to buy new clothes or go on vacation. My family shares a single, beat-up vehicle because we cannot afford to purchase a new one. My monthly grocery budget is about $300, which is the fee that you are requesting that I pay you every year. I could certainly make a higher income by charging my patients even more for their treatment. However, this would mean limiting the ability to care for even more patients who are already struggling to pay for my services.
You may have noticed that there is a lot the news recently about the nation-wide doctor shortage, and in particular, the shortage of psychiatrists to treat the vast mental health needs of our country. Please understand that your proposed “non-membership” fees are a significant contributor to this problem. Doctors, in general, are not selfish people. In fact, almost every doctor that I know (myself included) went into medicine out of a deep desire to help people in need. We are true-born healers and have nothing but the most sincere interest in our patients’ health and well-being. However, due to a broken healthcare system and variety of other factors, we literally have our passion wells sucked dry at every turn. We have to contend with monumental amounts of student loan debt, endless fees such as yours, documentation requirements that soak up 90% of our time, insurance companies who refuse to pay for services for our patients, and very ill patients who (through no fault of their own) demand so much of our time. Physicians already sacrifice almost everything in order to help their patients. We work most holidays, don’t see our families for months or years, and dedicate our lives to improving the health of our patients. There is nothing that we won’t and don’t do for our patients.
However, physicians are only humans. We need to eat, breathe, rest, and use the bathroom like everyone else. Although we are frequently seen as such, we are not super humans. We have our physical and mental limits, as do the patients we treat. And when we are bombarded by impossible demands, insurmountable debt and fees, endless fights with insurance companies, neglecting our friends and families, and working for shifts that never end, we eventually reach our physical and emotional limits. This is exactly why the national physician suicide rate is higher than any other profession, and nearly two times that of the general population. We are at a breaking point. Life as a physician is not sustainable in our current system. Physicians will continue to die by suicide every day if changes are not made.
When I received your letter, demanding that I pay a $300 fee to not be a member of your program, it was the straw that literally broke my back. My heart dropped because I knew that I could not afford your fees, but did not want to stop being a physician in the state of Virginia. I skimp and save every dollar that I earn, in order to make ends meet. I do this all for my family and so that I can continue to see my patients for a reasonable fee and provide the very highest level of care to each and every one of them. I do this because I care. I do this because the only thing that I know is that I can’t call myself a physician if I’m not actually healing my patients, like the oath I took to do.
So, all of this is to say that I do not have the $300 annual fee that you have requested from me to “opt out” of your program. You mentioned in your letter that if I do not pay this fee, I will be reported as a “non-compliant” physician to the State Corporation Commission. Perhaps this will mean that I will lose my license to practice medicine in the state of Virginia. If this is something that you think is a reasonable decision on your part, so be it. However, please know that each and every one of my patients will lose a psychiatrist who cares for them deeply and has nothing but their best interests at heart. Please know that my family will lose their financial support and I will be forced to seek some type of alternative employment. So you know, I will feel like I have betrayed every one of my patients who I took an oath to treat and protect. In addition, the state of Virginia will have one less qualified and licensed psychiatrist during a time of great need. If this sits well with you, then so be it.
The signatures below are from individuals and healthcare professionals who understand, support, and agree with my (and other physicians') decision to not pay your fee.
Thank you for listening.
Kendra Campbell, MD