I’ve been treating IBS and complex digestive conditions for over 25 years. And in all of those years, not once—literally not once—has a health insurance company asked me if my patient got better.

This is my story about that, and what they do say.

👋 Introduction

Let that sink in for a moment.

Not once has an insurance company called, emailed, or sent a form asking:

Did the patient improve?
Did the treatment actually work?
Did their quality of life get better?

Nothing.

⚠️ The Reality Most People Don’t See

It’s not that they’re asking the wrong questions.

They’re not asking questions at all.

They create a system—a game—and then they try to see if you and the doctors can figure it out.

Because it’s not done in a crystal clear and transparent way. It’s done with lots of coding and language you can’t understand, or that sounds really important.

What they do send me are letters that come across as very authoritative and say things like:

• “Improperly coded.” 📄
• “Not Covered benefit.” 🚫
• “Not medically necessary.” ⚠️
• “Denied.” ❌
• “Pre-authorization required.” 📝
• “Out of network.” 🌐

💥 The Predetermined Outcome

And you know what? I ignore them and do all kinds of things that they don’t like. Because I got into this business to do everything that I can to help people. Not to tell people that my hands are tied and that there isn’t anything else that can be done.

Because with insurance companies, the outcome is already predetermined.

They already know if you’ll get better or not. Because they determine what care will be paid for… and what won’t.

Before the doctor ever meets the patient…
before the patient ever explains their symptoms…

The insurance system has already decided:

• What you’re allowed to do
• How far you’re allowed to go
• And when you’re supposed to stop

Because they live by one rule:

“Don’t spend too much of our money.” 💰

📊 What The System Actually Measures

So the focus is not on:

Did you get better?

The focus is on:

Did you stay inside the lines?
Did you follow the approved pathway?
Did your doctor use the right codes?
Did you both avoid doing anything that isn’t reimbursed?

Not outcomes.
Not results.

Just whether the care fits within what they are willing to pay for.

🧠 What This Does to Patients

And here’s the really tricky part.

It leaves you believing that everything has already been done.

Because they’ll do a lot, even if it won’t help you. The system does allow for a certain amount of fancy testing that you probably don’t understand, even though that testing has been proven to not solve a majority of the problems that patients come in with.

But it’s allowed by the insurance company because it’s ruling out things that make a lot of money.

So you go away thinking”

That you’ve had all the right tests.
That you’ve had all the right treatments.
That you’ve seen all the right specialists.

When in reality… you’ve only experienced what the system allows.

Which is not even close to everything.

🩺 What This Does to Doctors

And it puts doctors in a difficult position too.

Because when you don’t get better, you still need an explanation.

So your doctor is likely to say things like:

“This is just something you have to live with.”
“We’ve ruled everything out.”
“Your tests are normal.”

Or maybe they don’t say anything at all and just ignore the issue.

Not because there’s nothing else going on—

But because the doctor is unwittingly caught up in the system, and probably doesn’t even know any better.

🔄 Why This Matters for IBS

This is exactly why so many people with IBS stay stuck for years.

They’ve done everything they were told to do.

But the system was never designed to solve their problem.

Because it’s not tracking outcomes. It’s tracking things like:

• Costs (how much was spent) 💰
• Utilization (how often services are used) 🔄
• Coding compliance (did it meet billing rules) 📄
• Basic quality metrics (like did you test the diabetes patient) 🩺

✅ How It Should Work

If health care were truly about helping people solve their problems, they’d be asking not only me, but you…

Yes, you!

Questions about meaningful clinical outcomes, such as:

• Did your symptoms resolve?
• Did your quality of life improve?
• Did the treatment actually work long-term?
• What worked?
• What didn’t work?

Has your health care insurance ever done that?

NO!

It’s truly dumbfounding when you stop and think about it.

💡 A Different Approach

In our clinic, everything revolves around one question:

Did you get better?

That’s it.

Not:

Did we stay within someone else’s guidelines?

But:

Did your life actually improve?

Because at the end of the day, that’s the only thing that matters.

It’s time to change the system. If you’ve been stuck in that cycle—doing everything you’ve been told, but not actually getting better—there is a different approach to help you.

I know, because for over two decades we’ve been helping people who had done everything and were completely out of hope.  In fact, we guarantee that you’ll experience significant improvement.

Call our office at 206-264-1111 📞 and see if you qualify to work with us.

And remember—take good care of your body 💙. It’s the only place you have to live.

Related Content:

IBS Isn’t the Answer — It’s the Beginning (Here’s the Truth)

Survival Care vs. Health-Improvement Care — Why the System Is Designed for the Wrong Goal

You’ve Been Diagnosed with IBS, Now What?

Why Don’t Other Doctors Treat IBS This Way?