Dr. Steven DeAngeles

Dr. Steven DeAngeles

The Chicago internist, 45, received his medical degree from Southern Illinois University in Springfield in 1989 and began seeing patients in 1993. He went "out of network" last summer.

When I first went into practice, I joined two older physicians. They were each seeing 12 to 16 patients a day. Doctors were still the quarterbacks, if you will, in the health-care system. You got to spend more time with patients. More recently, I was seeing 20 to 30 patients a day, with three times the paperwork per patient. It added hours to my day, to the point that the hours eventually ran out. I would get in at 6:30 a.m. and get home at 7 or 7:30 p.m.

Medicine is changing from a profession to a business, and it is being driven that way by the insurance companies. Doctors can charge whatever they want, but ultimately what you get paid is set by the insurance companies. Doctors should decide with patients when they need to seek care, not insurance companies.

About four years ago, I started a pilot program to get out from under the thumb of this puppet master. Patients got all my phone numbers and same-day appointments, if they wanted, and I would see them every day in the hospital for free. I charged $5 a day as my retainer if you're 35 and older. If you're younger, I charged $2.50 a day. I also simplified my fee structure for office visits: It's $50, $75, or $100. I accepted 100 patients in the program; it filled up in two weeks. A year ago, I converted 100% of my practice to this program. Now I probably see 10 to 15 patients a day. I have more time for them, because my paperwork has fallen off exponentially. I don't have a billing service anymore; that saves me $50,000 right off the top.

I have three daughters—22, 19, and 18. My oldest daughter graduated from the University of Wisconsin and is in her second year of a two-year program to become a physician assistant. She was talking with me about going into medicine, but I couldn't push her to get an M.D. because I'm worried about the profession.

I'm still pleased to be a doctor. I started out at $130,000 a year [and] make more than twice that today. But it's more than the monetary reward: I can hold a patient's hand and look in their eyes, and realize that I've helped someone. When I do that, I'm happy.