Are You Really Stupid for STILL Taking Insurance?

Why some doctors act like battered spouses when it comes to abuse from Big Insuarnce

Let me apologize in advance. This blog post will definitely anger some of you — but trust me when I say that my heart is in the right place. I very much am on a mission to “fix” chiropractic and make you guys waaaaaay more profitable and avoid the burnout that I am seeing all around the industry.

For the past six years now (perhaps longer) I have been pounding the table to urge our PBC members and Ben’s Apprentice Clients to reduce their dependency on Big Insurance and to “phase in” moving towards all cash.

What has been the result of the move towards 100% cash

Not once — I repeat that NOT ONCE — has a doctor that drop kicked insurance to the curb regretted it. In 100% of the time all my clients have raved about life “AFTER Big Insurance.”

Yet I still get massive resistance to this. It is like the abused and battered wife who continues to return to the hideously violant husband simply from — FEAR OF THE UNKOWN. To the spouse, the fear of change is GREATER than all the abuse and battering.

This short article below from a recent Dan Kennedy newsletter will perhaps change your mind about insurance once and for all.

Dan Kennedy Case Study — Doctor’s Drop Kick Insurance to the Curb and Live to Talk About It

From the January 2012 No B.S. Marketing Newsletter by Dan Kennedy:


In a town in North Carolina, Dr. Brian Forrest, M.D. had had enough with insurance billing complexity and costs, worried over Obamacare, so he stopped accepting insurance – period – and decided to deal only with patients willing to pay him directly.

He imposed a $399.00 yearly ‘membership fee,’ but then charged less for most services than he had billed to insurance companies, and slashed the number of patients being taken care of, but quickly found his practice was more profitable – given zero collection costs, and a 2/3rds reduction in overhead.

He’s able to spend more time with each patient, provide quicker access and better service, work less, manage a lot less, and make more money. He and two other M.D.’s have also pioneered their own direct-buy health plan that businesses can purchase for their employees instead of traditional health insurance – and under the Obamacare rules, providing this exempts employers both from requirement to provide insurance and the fines/tax for not doing so.

So the “surprise” here is that you can dump 2/3rds of your customers and with them 2/3rds of your overhead, deliver superior service to a smaller number – and increase net income.

So I repeat my original question…

Are you stupid for STILL taking insurance? Oh yes, I too can recite the 101 plausible reasons you will try to give me to explain why “YOU” are different, unique, and in a position where you simply “have” to take insurance.

Know what I say to that?

Total bullsh*t.

I work with more DC’s than perhaps anyone in history, certainly been around the block longer than 99% of the consultants in our industry, and I can tell you this:

There is no reason Big Enough that you could ever give me, for putting up with the battering and abuse you have been putting up with from Big Insurance. Period. Big insurance is an illusion — you “think” it provides income and stability but that is a desert mirage.

Insurance = Net Profit Killer Par Excellence.

Instead taking insurance is a Net Profit killer, it mentally destroys most, and overhead costs skyrocket so that you can “make more” from insurance. Can you say — battered spouse syndrome?? Fear of the unknown is keeping you enslaved to insurance. That is a fact. Ask any Business Person – not a chiropractor – and they would look at the numbers, the situation, and what the trust “costs” of taking insurance, and they would say:

“Are you insane to continue to do this? That is a BAD business model.”

All I ask is this: That you give VERY serious consideration to what you’ve read, the actual experiences of MD’s — who are even more entrenched in insurance than chiropractic – and even by “losing” 2/3rds of their patient base their net profits are UP. Just let that little tidbit sink in, and you might just change your practice and your life for better.

Okay… post your comments below! I’m ready for ya!

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23 Responses to Are You Really Stupid for STILL Taking Insurance?

  1. Jared Hymas January 24, 2012 at 11:52 am #


    I know you probably talk about this a lot in your membership site, and when I’m not a poor chiropractic student maybe I can find out 🙂 But my question is, if you are just starting out into practice and you don’t have any patients at all, let alone 2/3rds of your patient’s to kick out, what would be the best way to build a cash practice without going broke to start off with?

    Trust me I plan to GOYA and all that good stuff I have learned from you, but any advice for the current chiropractic student looking to start a practice out of school, would be appreciated.

    Thanks Ben,


    • Ben Cummings January 24, 2012 at 12:07 pm #

      Operation Rootstock! It always works.

      One patient gotten from Operation Rootstock = One years worth of PBC membership dues 🙂

      • Jared Hymas January 24, 2012 at 12:25 pm #

        LOL it is very true. I do believe that to be successful you need to associate with other successful people, and have a good coach.

        Anyway, I still have one year to graduation. I’m just trying to get prepared so that I can hit the ground running when I graduate.

        • Ben Cummings January 24, 2012 at 12:28 pm #

          Sounds good. You are very smart to be studying this stuff NOW. You will do well!

    • Bryan Hobson January 24, 2012 at 5:36 pm #

      Operation Rootstock 1st….Twitter marketing 2nd…….Facebook 3rd and MD referrals 4th. ALL of these are next to $0 to implement and ALL of them work. Very well in fact.

      Bryan A. Hobson
      FormerlyThe World’s Greatest C.A.

      • Ben Cummings January 24, 2012 at 6:22 pm #

        Bryan – great tips. Don’t you love the fact that he’s not graduated and yet he is already pursuing success in practice? I love this guy!

      • Jared Hymas January 25, 2012 at 12:00 pm #

        Great thanks for that advice. Over the past year I have been working hard to understand and use twitter, under a pen name though just because I wanted to figure it out.

        I won’t deny it though that I haven’t quite figured out how to use facebook effectively. That is definetly on my to do list.

        And as far as MD referrals go, I heard a really good tip once where this doc sent out a monthly newsletter to MD’s who he knew to be referrers to chiropractor’s. The newsletter would focus on areas of common ground between our professions. That way he was always on their mind at least once a month.

        And of course Operation Rootstock was really the impetus that started me thinking about my future career as not only a chiropractor but also a business person 🙂

        Thanks again I really do appreciate it!

        • Ben Cummings January 25, 2012 at 4:27 pm #

          Thanks for the good to Jared – glad you’re enjoying things at the PBC blog!

  2. DocNielsen January 26, 2012 at 12:17 am #


    Loved the article about insurance.

    I think the reason more of us don’t ditch this insurance mess
    is because of the uncertainty of our profession’s future.

    To date, we still don’t know if ObamaCare is ahead for us
    (or not). It’s all confusion. No one knows what is going on.

    And as you know, a confused mind (or doctor) says…”No”.

    • Ben Cummings January 26, 2012 at 8:20 am #

      I understand. But when you go cash — like the REST of all businesses on planet earth are “cash, check, credit card maam” — you release all the nervousness about Obama care etc because you are opting out of that system. A system for which, I might add, you will never win 🙂

  3. Norm Price January 27, 2012 at 6:16 pm #



    I did listen a number of years ago to people like yourself warning of the true cost of being dependent on insurance. As a result, I do not participate in any insurance programs and I’m 85% cash based.

    The overhead stays low, my very small staff is extremely thankful, and I have no accounts payable.

    Thanks for telling it like it really is!

  4. Matthew January 29, 2012 at 4:21 pm #

    I hope I smell a PBC Member newsletter in the works!!!! I’ve held on to insurance because I had some good payers until about a year ago. but now it’s mostly “that’s the way we do it because that’s the way we’ve always done it” and that’s not like me! I’ve already told the staff that I am shooting for dumping most insurance by 2013. Is there any time of year that’s better (other than NOW) lol?

  5. Burdoc February 9, 2012 at 11:32 am #

    How can a chiropractor ethically turn away medicare patients that you can’t legally see if you don’t deal with medicare?

    As much as it is nice sounding to not take insurance, if I did that I would have no patients at all. I would rather be collecting some insurance than collecting no money at all.

    • Ben Cummings February 10, 2012 at 9:09 am #

      The rest of the business universe – including the two MD’s featured in the blog post – all live in the world of “Cash.” Hate to tell you, but this is a scarcity-mentality that is in your own head. You seemed to have ignored the part in the blog where I said that in all my years consulting with docs – yes, docs in exactly your shoes because trust me you are not “different” than any of them – when they drop-kicked big insurance they never regretted it.

      So, choice is yours, but I can you that your assumption about “making no money if you didn’t accept insurance’ is total bull. It is simply not accurate – so you may want to consider a new viewpoint unless you love treating cases in which you are sorely underpaid. Aside: if the only cases you treat are medicaid/medicare, who’s fault is that? Who attracted these type of cases? That’d be you. Your marketing (or lack of it) is attracting the wrong market that makes you no $$ to sustain a viable business. Time to readjust the aim fo your “Marketing Bow & Arrow” to start nabbing a much better demographic. A demographic that isn’t broke/old/solely dependent on Big Gov’t to take care of their health needs.

      That’s similar to the local inner city corner grocery store, solely dependent on the food stamps of their clients, to sustain their store. Uh, maybe that’s not the best demographic to be servicing if you desire a vibrant, thriving, high-margin practice, with tons of referrals, and a clientele that can purchase other products/services. Just a thought.

      Remember – I am fighting for your cause and to help your income. Big insurance is NOT so don’t confuse your loyalties 🙂


  6. drfacquet February 13, 2012 at 7:10 pm #

    One look at what comp did to the chiropractic community in NY… the Texas WC changes where plans can choose not to include chiropractic…the crap reimbursement rates for Chiro in NYS under the rationed care plans (HMO, PPO) all in the name of cost containment….what bs…We are the whipping boys of the insurance industry…functional medicine…the new docs may know this well – the older try to catch up…all leading to ridiculous documentation requirements that are only for a carrier to use to take back money from you…makes no sense – for any profession…there is no time to read all the bs…except the carrier’s goons…do more work get paid less than it costs you to do the work…time to focus on cash (the dentists were smart)

  7. Dr. Nick February 17, 2012 at 4:12 pm #

    Thanks Dr. Ben, I LOVE the idea of going all cash, but in my area of southern california all the other chiro’s are taking insurance and people are expecting to use it and if you don’t accept it they know the guy next door who also has a nice office does. I’ve lost HMO patients who came in off a promotion because I don’t accept it and they thanked me for reminding them about the importance of chiropractic and they are going back to their old chiro who takes their insurance to get started again. I don’t plan on joining networks, but if people are paying a lot of money for a good PPO, why not accept their insurance since they’re going to pay for your services?

  8. mike July 19, 2012 at 10:17 pm #

    your logic is sound.

    However, I am all personal injury. No need to worry about insurance, thank God!

  9. Roger August 4, 2012 at 7:33 am #

    Here’s a suggestion to those taking ins. You should have your staff give you a daily report of your collections. The total amounts should be split into ins. & cash/out of pocket pay. Immediately you’ll know how codependent you are on ins. Now you can start to move away from ins. (by creating a more a attractive cash plan) and actually measure how much further you need to go before you break the relationship the abuser.

  10. Dr. Al September 23, 2012 at 11:22 pm #

    Dear Ben,
    Although I do bill insurance for my patients I do not accept assignment and have been a cash pracitce for 30 years. It is really great to have my daily income and production totals match at the end of the day….however, some of my patient’s have been with me for those 30 years and are now Medicare patients. I understand if I don’t bill Medicare for these patients I am not allowed to provide chiropractic care for them and after their years of confidence and loyality to me I feel really bad turning them away… can I stop billing Medicare and still legally see my Medicare patients if they sign an ABN at each visit choosing option 2 requesting care but instructing me to not bill Medicare for the service?
    Also, would I then be allowed to charge them more than Medicare’s limiting charge for my service?
    Thanks for Chiro Bullets….the information is great!

  11. Seth LaFlamme, D.C. November 1, 2012 at 8:33 pm #

    I am loving my first few weeks as a PBC member. I am looking at this post from all angles, though, and I don’t see me reducing my overhead by 2/3. Not even 10%. And my per visit collections will be less. Tell me if I am missing anything, but I only pay 8% to my billing contractor, and my CA spends a couple hours a week going over superbills. That’s it. No “insurance dept” or any other costs. Plus, the average visit around here, cash, is about $40. Cash plans drive it further down. When I see an Anthem patient, and do an adjustment, as well as either extremity or mechanical traction, I am getting paid $49 to $64. So my average is about $57 a visit. Even if you round my billing costs up to 10%, and round that up, I’m getting $51, and the other insurances in my area pay better or equal….Anthem is just the most common. So, an extra $11-$26 per adjustment (one local doc only charges $25 cash) even with added costs of dealing with insurance factored in. Where is my math wrong? I’d love to cut them out of the picture, but now that the waiting period is over to starting to get paid, I am getting paid well, and My billers go after my money like rabid bulldogs and it is flowing without a hitch. I can’t see the reality described above. How exactly could I profit the same, in that scenario, with 1/3 the patients? If I’m missing something I am dying to know. This post doesn’t bother me at all, but I am not yet in agreement that insurance is no longer profitable. I’ll take the checks while they are still there to be had.

  12. Dr. M Greene December 10, 2012 at 3:34 pm #

    I’ve been dealing only cash for 15 years and would never go back!


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