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1952 letter to the ed from an insurance company

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1952 letter to the ed from an insurance company

Post by greg parker on Wed 02 Apr 2014, 9:27 am

The following letter was in the March '52 edition of the Texas Osteopathic Physicians Journal. It is very delicately worded. But make no mistake. The gist of the letter is that a lot of Osteopaths were only interested in how much money they could wring out of patients and insurance companies alike. 

Dear Dr. Gafney:
I herewith acknowledge your favor 
of January 29th relative to the creation
of committee on industry and insurance
and am further glad to note
that you are selected or appointed as
chairman of such a committee.
A mental review of our past relationship
with Osteopathic Physicians and
Surgeons and Osteopathic Hospitals indicates
to me that such a committee
for the purposes and intent indicated
is highly necessary, in that, we have
experienced from time to time some
unsatisfactory relationships with various
Osteopathic Hospitals as to billing
practices and with individual Osteopathic
Surgeons who have made a wide
departure from accepted standards of
Osteopathic medical background, as to
the inception, duration, and causitive
factor requiring hospitalization of our
policyholders. Do not misunderstand
me in making this statement, as we
find that M.D.s in a great many instances
deserve the same criticism and
individuals in the profession demonstrate
an arrogance that, if nothing else,
puts severe strain upon the relationship
between the professions, Osteopathic
and Medical Doctor, that definitely
should not exist.
I have personally watched the development
of Osteopathic institutions,
and the broadening of Osteopathic techniques 
over the past few years into
fields of practice and surgery for many
years reserved to the Medical Doctor,
and I feel that this development was
occasioned, to a large degree, on the
failure of the M.D. to function at a
proper level and it would seem that
the Osteopathic group has certainly
realized the needs of the public and has
met the challenge. I believe that you
must realize that many of the insurance
companies offering hospitalization type
insurance realized that this was true in
their decisions to include Osteopath and
Osteopathic institutions in the participation
of benefits under their policies,
instead of the restricting of same to
treatment by M.D.s. Certainly, this
realization should tend to create a relationship
between Osteopathic institutions
and individual Osteopathic physicians
and surgeons wherein the industry
could feel that such recognition on their
part of the development of the Osteopathic
practitioners would justify its actions
and in most instances, I feel that
same has been justified.
However, as pointed out above, generally
some isolated Osteopathic institutions
are apparently bent upon "killing
the goose that laid the golden egg",
so to speak, and has caused a great deal
of discussion among the many companies
comprising the industry as related
to your group.
It occurs to me that the Osteopathic
physicians and surgeons are filling a
great need for medical services, especially
in the smaller communities and as an
incident thereto, it appears that the Osteopathic
institutions and the individual
Osteopathic physicians and surgeons are
more insurance conscious than necessary,
and in manv instances are not giving
to us the information available to them
relative to individual claim, to which
we are entitled, or which would cause
a rejection of the individual claim by
the Company. We can readily understand
the general disposition of the individual
to assist the people that he
knows in the small communities, or in
the larger communities for that matter,
but I think that such individuals should
have brought to their early attention
the fact that in the long run they will
receive more benefit and our policyholders
and their patients will receive more
benefit should such institutions and individuals
work closer with the insurance
company, that when claims are presented
the insurance company, said company
will be able to quickly evaluate
the merits of a claim and handle same
in accordance with its policy provisions,
without having members of its Claim 
Department to develop prejudices
against Osteopathic institutions and Osteopathic
physicians and surgeons, based
upon unsatisfactory situations in the
memory of the Claim Department member
and which occasions doubt in the
minds of the Claim Department as to
authenticity of any claim originating
from such individual source. Speaking
generally, but having in mind a few
instances of the sort, I might point out
that one of the most trying incidents
is where from the reports as submitted,
a claim clearly does not fall within the
province of the policy and is rejected,
following which the Claim Department
receives an entirely different picture by
letter of the situation which causes confusion
in the mind of the claimant, and
places the reporting physician in a class
with any company's Claim Department
as being unreliable and considered as
being subjected to pressure or is interested
from financial stand point to the
extent of such change of diagnosis,
treatment, surgery, etc. This, it appears
to me, should be eliminated and we
wish to assure you that this Company
will bring such matters in the future to
your direct attention.
Our final thought in the matter is
to the effect that if Osteopathic physicians
and surgeons are qualified physicians
and surgeons, and if Osteopathic
institutions are kept and set up for the
purpose of rendering necessary hospitalization
to persons suffering with abnormal
conditions, then such individuals
operating such institutions and performing
as Osteopathic physicians and surgeons
should definitely be able to give
the insurance companies an unvarnished,
factual and intelligent statement of the
factors involved in support of the claim,
and place such facts in the hands of the
insurance claim departments, because in
its final analysis, the only thing that the
claim department wants is the facts
about the claim, its inception and the
necessary procedures employed to correct
same.


The same journal has a number of ads for Osteopaths. Philben's ad clearly states "practice LIMITED to pediatrics". However, whether or nit he was a "qualified" Osteopath of Pediatrics in 1945 is not clear cut since he may have been in Philadelphia at that time completing his residency requirements.


_________________
Mixing Pop and Politics he asks me what the use is
I offer him embarrassment and my usual excuses
While looking down the corridor
Out to where the van is waiting
I'm looking for the Great Leap Forward

            Billy Bragg
-----------------------------
 Australians don't mind criminals: It's successful bullshit artists we despise. 
             Lachie Hulme            
-----------------------------
The Cold War ran on bullshit.
              Me

greg parker
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