29 Pine Brae Drive, Skillman NJ 08558
609-474-HEAL (609-474-4325)     Fax: 609-644-4400

Subject:  Choosing to be an 
                 "out-of-network" doctor

From:      Deborah Ginsburg MD  

To:           Her patients

To my patients and friends,

It has been a difficult decision for me to decide to not participate in the modern insurance system and the restrictions they place on providers of health care. I have put an enormous amount of thought into it.

Patients of Healing Oceans will still be able to get out-of-network reimbursement from their insurance companies, but we will not accept their influence on how we practice medicine.

With this in mind, I have tried to set reasonable rates and be creative in developing payment plans that enable as many as possible to come. (You can see more about those  if you click here.)

A Health Care System in Crisis: Health care is right now caught in a terrible situation. There is a huge problem with the insurance system, which has caused the US to rank dramatically low in health outcomes from doctors. We have been falling farther behind each year, despite spending more money per person than any other country. The United States is now ranked 37th in the world, behind Japan (10th), Ireland (19th), and Colombia (22nd).  (The New England Journal of Medicine report

A big reason for this is the way the insurance system works. They allow a minimal (or even money losing) rate for those physicians who concentrate on building wellness with patients, but reimburse generously for those physicians that do surgery or procedures or resort to quickly prescribing a drug.  (And they do this even though their cost for physicians’ fees is only 8% of their total costs.)This practice forces many doctors to see so many patients that they cannot give good care. In the USA, our population is getting sicker, not better.

I have had the luxury in the past 14 years of working in an academic environment, teaching medical residents in a practice subsidized by UMDNJ. This allowed me to develop my style of a more holistic medical practice without the same restrictions that other doctors have.

To practice the kind of medicine that I believe I must practice, I cannot allow the insurance companies to dictate the style of care I offer. Instead, I stand committed to practicing sound medicine that creates health, to drawing patients into ever more vital lives and lifestyles,. I also commit to provide much greater access for patients than is normal in the system, using email, our Health Hub,  and other resources.

It is also true that the US ranks even lower in the "Fairness of financial contribution to health" category. This is a measure of how fair each country is to its citizens in its system of paying for medical care. Getting good health care in the US can be expensive for citizens who are not wealthy. Compared to other countries, the US ranks 54th in the world, behind Banglasesh.  

There is actually a bit of a movement building among some doctors to not participate in the U.S. insurance system. The.efficiencies created when they withdraw often allow doctors to even charge lower rates than they charge in the insurance system, while providing the better quality of care, richer relationship with the physician, and easier access that is at the core of good medicine.

I appreciate any suggestions you may have.

Thank you again very much. 

Deborah Ginsburg, MD

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