Doctors Fight Coverage to Give Care, Writes AAPS president Juliette Madrigal, MD


While all the talk on healthcare reform focuses on “coverage,” Juliette Madrigal-Dersch, M.D., who practices internal medicine and pediatrics in Austin, Texas, explains how coverage is often an actual barrier to care, in the summer issue of the Journal of American Physicians and Surgeons.

Dr. Madrigal-Dersch is the president of the Association of American Physicians and Surgeons.

“The more insurance companies and the government impose their interests on doctors and patients, the more difficult providing care becomes,” she writes. “Caring enough to fight through the barriers third parties place between doctors and patients has unfortunately become a crucial part of the practice of medicine.”

Patients who have “great insurance coverage” are often unable to get the medications their doctor thinks most appropriate for them, she states. In one case, a medication was approved after many letters back and forth to the insurance company—two weeks after the patient’s death.

Another patient could have died because her insurer took so long to approve an urgent magnetic resonance angiogram to look for a ruptured aneurysm in the brain. “If she had not had insurance I would have been able to get her MRA [within two hours] at almost the same price as what turned out to be her deductible.”

The patient said, “If I had known all this I probably would have just paid for it myself but being put off repeatedly I just kept thinking it was about to happen.” As Madrigal-Dersch notes, patients are paying high monthly premiums for insurance that promises to cover such items.

“Would any of us have gone to medical school knowing we would spend our days fighting insurance clerks and government interference in the practice of medicine?” Dr. Madrigal-Dersch asks. “While our nation has been divided and distracted by ‘ObamaCare,’ the insidious actions of third-party payers continue unabated. Daily we fight just to get our patients the treatment they need.”

The Journal is an official publication of the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, which was founded in 1943.

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