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Walking in his patients' shoes

Will Nicholson, M.D

As a family medicine resident at St. John’s Hospital in Maplewood, Will Nicholson, M.D., saw every day how health insurance coverage affected the care his patients received. Patients wouldn’t get the medicine he’d prescribe because they couldn’t afford it. Or when they had health concerns that needed follow-up, they’d be charged for another office visit and often any diagnostic tests that were done.

“I was taught that you always put patients first,” says Nicholson, University of Minnesota Medical School Class of 2006, who’s now a hospitalist at St. John’s. “If it’s the right thing to do, you do it.”

But health insurance—or lack thereof—kept getting in the way of optimal care. Even in Minnesota, which historically has had one of the lowest rates of uninsured people in the nation, the number of uninsured people rose from an estimated 374,000 (7.2 percent of the population) in 2007 to 480,000 (9.1 percent) last year, according to a new survey by the Minnesota Department of Health and the University’s School of Public Health.

So Nicholson decided to conduct an experiment. For six months, he’d opt out of his employer’s health insurance plan and purchase short-term policies as an individual through the consumer market—just as many of his patients have to do. Starting in July, when he completed his residency, Nicholson tried a new plan every month.

Even as a physician, he found that the paperwork and fine print made his head spin. Yet when the six months were up, Nicholson decided to keep going with his experiment.

“I hate to make conclusions with incomplete evidence,” he says. “I want to give the market a chance to work. … I’m still optimistic, but before I give too much criticism, I want to leave no stone unturned.”

So far Nicholson has found that each insurance provider has an extensive menu of coverage options, and he has discovered the importance of knowing what each package does not cover. He also has struggled with quantifying his risk of getting sick and finding the right balance between not paying too much while getting enough coverage “just in case.”

To his surprise, Nicholson’s experiment has received media attention from outlets such as CNN and Minnesota Public Radio. The sudden spotlight has made him realize people’s immense hopes that someone is digging into the issue.

“They want to hear that someone’s really doing something, that somebody’s putting themselves in their shoes, that they’re not alone.”

By Nicole Endres

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