What would happen if patients paid doctors whatever they thought a office visit was worth?

A handful of physicians decided, for one day only, to offer patients the option to pay only as much as they could as an experiment to see how people really value primary care. Physicians chose their own dates for a pay-what-you-can day and got the word out. On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who needed additional services were referred to various public resources. Practices also handed out lists of generic medications available for reduced prices at large, discount pharmacies.

Overall, participating physicians said they learned that although patients valued the physician visit enough to pay something, the payments were below actual cost. Still, most valued it enough to pay something. Some patients were unemployed and paid nothing; some paid $100. Visits were as short as 10 minutes or as long as an hour. Some people scraped up $20, some paid $60 to $80. One patient, a waitress and college student, paid $80, mostly in singles. The doctor gave her $20 back.

None of the participating physicians collected enough money to make the concept financially viable over the long term, mainly because payments didn't match a typical day's collections from insurance and co-pays. Yet most say they want to do it again and enjoyed having one day free from insurance paperwork. Doctors found it was satisfying to be of service to people who have a need, even just for one day.

Physicians discovered an unanticipated and unintended benefit: Pay-what-you-can days can help build a practice. Local media coverage may increase a practice's profile, and patients from pay-what-you-can days might return when they do have insurance.
Pay-what-you-can days also brought an unexpected amount of goodwill to medical practices and produced public recognition within their communities, physicians said. Participating physicians say they have been stopped on the streets and in grocery stores by people thanking them for their efforts.

When a local newspaper ran a story about Will Conner, MD, a family physician in Matthews, N.C., holding a pay-what-you-can day at his Conner Family Health Clinic, one of his patients who was a nurse volunteered to help. Someone else dropped off a flower with a card that said Dr. Conner was "receiving this because you have done something nice. "The pay-what-you-can day "definitely got recognized. We know we did the right thing," Dr. Conner said. "It's not very practical to do every day, but it is good for the community, and good for patient care."