I graduated medical school in 1995. I believe in a single-payer health system. I am about championing for my patients. I left a salaried position in academic medicine to go an underserved area of rural Maine and start a practice. This is the letter I wrote to the CEO of a large health insurance company recently.

Dear Mr. CEO,

My name is Cathleen Greenberg London. I am a family medicine physician who left Cornell in New York City to go to rural Maine and open a practice in an underserved county. I bring with me 21 years of experience. (Prior to my teaching position I had a practice in Brookline, MA and taught for BU and Tufts.)

I grew up around the insurance industry; my father is Maurice Greenberg, formerly of AIG.

Imagine my surprise when I received a contract from your insurance company without any fee schedule. I was then informed by Ms. Negotiator that the fee schedule would only be provided after I signed the agreement. A “provider” agreement.

I went to Yale School of Medicine. I did not go to provider school. I am an experienced physician who keeps her patients healthy. I have enough experience to treat 80 to 90 percent of medical problems. I use alternative treatments as much as allopathic medicine.

I received a phone call from the manager of Maine contracting yesterday who wanted a list of CPT codes from me. I tried to explain I am a true family medicine physician.

I also explained at this point in my career anything under 150 percent of Medicare rates would be unacceptable.

He said he could not meet that.

You made $17.3 million last year. You gave your lowest earning employees a 33 percent raise. You have yoga classes for your employees. None of this benefits your subscribers.

I am in the town of Milbridge, Maine in Washington County. I operate essentially like an ER; I have evening hours, weekends as needed, put in IVs, in addition to board certification I am ATLS, ACLS and PALs certified.
This is nonsense.

I have no problem staying out of network, but it hurts patients.

I am starting a direct primary care (DPC) model due to the headaches like this. I will take Medicare, Medicaid and enroll everyone else in DPC because predatory practices such as this are nonsense.

Let me know if you want to actually want to help people, or just your company and stockholders.

Sincerely,
Cathleen London, MD

Today, I got another phone call from the head of contracting for Maine that they could not move on their numbers. He wanted to know if I wanted to move ahead with a contract. I declined and hung up.

Instead, I completed my direct primary care agreement. I will contract directly with my patients instead. For a fraction of the cost and no administrative nightmares my patients will get the care they need right here in Downeast Maine.

Cathleen London is a family physician.

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