Alpine Naturopathic Clinic

I am responding to the "complaint" submitted by the patient Firstly, it is very sad and heartbreaking that the patient chose to "go public" with this instead of calling our office first We would have gladly adjusted the bill based on financial hardship; we do this whenever we are
contacted in these situations The situation in this instance is very unfortunate as their particular insurance plan applied all their appointments to their high deductible plan Patients are usually shocked when they get these bills as most patients are not aware of the costs involved in medical care Most patients are very very grateful of the time I spend with them I don't have an assembly line medical practice I choose to spend 1-hours if necessary for complicated casesBoth the medical cases here, mother and son, are very complex and complicated Initially they were very grateful for the time I spent with them "Excess conversation"? The "conversation" referred to is the deep in depth questions that I ask to get as complete a history as possible to figure out very complex cases: some that don't even have labs to test for the diagnosis In their cases, I suspected environmental exposures I asked questions about diet, sleep, Bms, where they live, age of building, past locations they have lived, water sources, food sources, camping, drinking stream water, travel locations, countries visited, comparing known historical events in certain countries to extend to patient exposure This is all part of the huge field of environmental medicineMost my training and patient approach is based on environmental medicineSo what may seem to be "extraneous" conversation to a patient is actually very important in trying to solve very complex casesThe family initially sought my care for their sonAfter being very pleased with our interaction and rapport, the wife chose to schedule an appointment with me after I saw her son In fact, due to the extensive history taken on the mother, along with confirmatory testing, I diagnosed 3-major health issues; one which may have even saved her life After her last appointment with me, she and her husband left very pleased and happy We were in process of getting the rest of her son's lab results and going to schedule a follow up appointment to assess all the testing and formulate a treatment plan I must also add that English is not the patient's first language She always brought her husband (and their children) to every appointment with me Several things had to be translated to the wife so she had better understanding of what I was saying Due to the relative language barrier, it would have been difficult to just "carry on meaningless conversation" I think another issue here is that patients who are used to socialized medicine and/or HMOs and have never been to a naturopathic doctor may not have ever had to pay more than a co-pay for a medical appointment They also may not understand why a doctor would spend 1-hours with them and not just minutes To that person it may appear to be "excess" conversation What is not reflected in the billing is the 15+ hours I spent in the evening researching both her and her son's cases This is time not billed for but research time I put into their cases to tackle what I refer to difficult cases I must also add that this is the 2nd time the patient has lashed out at me Instead of calling me with issues or concerns, she went right to threatsI reached out and contacted her times and she ignored all my attempts to contact herThe reason she had not received her lab tests yet was because I was still waiting to hear back from the patientI am a very easy person to talk to and reason with The patient does not need to hide behind a keyboard typing out threats and accusations She seems to have no interest in communication with me: and I have NEVER NEVER given her any reason to feel that I am not approachable In fact, I am so approachable and comfortable to be with that her son wanted me to do a follow up procedure and not the lab For his comfort and the family's comfort, I did the procedure in office which almost no other doctor will doThe whole procedure took over an hour; I even packaged everything for them for shipment so all they had to do was drop it off at FedEx to go to the lab In closing, I will formally state that I would be more than happy to gift the family a 30% off the billingThis patient broke my heart with her accusations and hostility She may never understand exactly what she has done here But I can step forward and offer the discount and a prayer that she and her son get the help they need I pray for her son's sake that he is able to get the help he needs Most sincerely, DrS***

Complaint: [redacted]I am rejecting this response because:
I am not satisfied with the response by Dr. S[redacted]. There are several statements made that are irrelevant to the original complaint of being overbilled. However, since she brought up various points, both personal and of her practice, I feel I do need to respond. Dr. S[redacted], failed to mention why we stopped visiting her practice. During our last visit she strongly recommended a medical treatment I was not comfortable with. Reluctantly I accepted, but I did not feel well afterwards. Unfortunately she does not answer her phone during business hours and only responds to emails in a timely fashion so I was unable to verify my reaction. Also during that procedure (an infusion), I was not comfortable with the fact that there was another patient also receiving an infusion at the same time. What would have happened if both of us needed medical attention at the same time but she was the only one in the office? That does not seem like a safe practice. Regarding her defense of excess conversation, she did not mention that she also discussed matters that were not related to any background information for her records. She told us stories of her travels, personal stories, and why we need to move from the city where we currently live as examples. She also happened to mention these same stories on multiple occasions. There were office visits where we finished discussing medical related topics fairly quickly, and she kept having unrelated conversation even if we’re ready to leave. I also have to add that she did not perform many tests in her office. We paid out of pocket thousands of dollars for tests she recommended which we had to do ourselves and mail in.   
Our primary complaint with her practice is being overbilled. Dr. S[redacted] never gave us a receipt or a bill for any of her services until after we stopped visiting her practice. If I had known what the true cost of her treatments would be, I would have sought other options. At the time during our visits, she assured us that we were covered by our plan. When we would ask for a receipt at the end of our visits, she did not give us any. Dr. S[redacted] needs to be more up front on her billing practices. In referencing her rebuttal, “I think another issue here is that patients who are used to socialized medicine and/or HMOs and have never been to a naturopathic doctor may not have ever had to pay more than a co-pay for a medical appointment.” If naturopathic medicine is so unique in how the charges are accumulated, then she needs to stress that first before any “treatment” is administered. Due to the vague billing practices that Dr. S[redacted] employs, I feel that it would be appropriate to be responsible for only 40% of what we were billed.
Sincerely,[redacted]