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01 July, 2011

Doctor as Renegade -- Accepts Cash, Checks, Eggs or Pie, Not Insurancs

Doctor as renegade -- accepts cash, checks, eggs or pie, not insurance | Minnesota Public Radio News: "... It's more a scene from the days of frontier medicine than from the modern health care system. And that's because Rutten Wasson, 42, is a throwback to a time before HMOs, electronic health records and hospitals with fountains in their lobbies. She sees patients the same day they call if she's not booked up, spends at least a half-hour per visit — compared to the more typical 15 minutes — and usually charges only $50 for a consultation. She takes cash or check, but no insurance — and sometimes accepts gratuities of a dozen fresh eggs or a pie.

'I have a few bottles of homemade wine in the fridge from patients,' says Rutten Wasson. 'In summer, I'll get pickles or tomatoes. I've received pork sausage, the kind that would convert a vegetarian.'

Rutten Wasson is decidedly not a vegetarian. She and her husband raise sheep and chickens she butchers herself. 'Occasionally, I have people pay me more than my fee because they think I've earned it. It's nice. I don't complain.'

In an era of high overhead, ever more byzantine regulations and payment models, cuts to Medicaid and Medicare benefits, and large medical systems swallowing independent practices, Rutten Wasson relishes her straight-forward manner of practicing. Since many federal health care reforms — such as those requiring electronic medical records — are tied to Medicare, they tend not to apply to her.

Her practice serves as a critique of the modern health care system, the complexity of which has pushed some providers and clinics to find dramatic work-arounds, despite the fact that it can be tough to make a living outside the mainstream...

... Rutten Wasson hails from Michigan, where she attended Wayne State University School of Medicine in Detroit and did rotations at Detroit Receiving Hospital. There she got a crash course in trauma medicine. 'I started my residency with an enormous amount of clinical experience,' she says. 'I was very well prepared.' She did her post-graduate training, specializing in internal medicine and pediatrics, at the University of Minnesota. Her first job as a physician was with Allina Hospitals & Clinics in the Twin Cities.

It didn't take long before Rutten Wasson became disenchanted. She was shocked to learn how much money the clinic brought in. 'They made four times what they were paying me. I looked at that and thought, where is the money going? Rent can't be that high. I had the most hideous art and ugly furniture. My assistant wasn't paid that much. Where is it all going?'

She answers her own question. 'It was going to administration, tiers and tiers and tiers of management, all of whom were busy making rules to make them look busy. Mostly they made my job more difficult.'

What bothered Rutten Wasson most, though, was that she couldn't give a break to patients without insurance. 'It's hideously unfair that uninsured people are given a bill for $375 and are expected to pay the whole thing, while the insurance company pays between 60 and 75 percent. It's not right. People without insurance are subsidizing people who have it.

'I view medicine more as a ministry than an industry,' she says..."


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