“A man’s gotta know his limitations.” ~Dirty Harry Callahan


“A man’s gotta know his limitations.” ~Inspector Harry CallahanHave you ever been the guy driving down the road in the wrong direction but didn’t mind it so much because you “were making good time?”

I thought of this while reading a recent article in Medical News describing the rethinking of treating a particular illness – in this case autoimmune disorders.

It indicates that the conventional wisdom of how to treat this disease may be EXACTLY the wrong way to treat it. Perhaps we’ve been traveling at increasing speed in the wrong direction.

The claims payment side of the insurance industry is often like this. Frequently we get locked into a particular course of action, and we’re very reluctant to change. Often course corrections are overlooked because “it’s not my job,” “they don’t pay me for that,” “don’t worry, we can pass on the cost next year” or the ever reliable “we’ve always done it that way.”

Medicine is changing constantly, and payors are responsible for staying current. How else can we be both good stewards of our clients’ money and also fair to claimants and patients?

The best way may be to be very aware of what we don’t know. Just like Dirty Harry in Magnum Force, “a man’s gotta know his limitations.” Just like good primary care physicians who know when it’s time for a specialist. Or just like our research physician discovering new and better ways to treat autoimmune disease.

The moral of the story is striving to improve, looking for a better way and being open to (or even encouraging of) change.

There often is a better way to do things.  There often are people who can help. That’s what we’ve been about for thirty years.

Call us. We can do better.

William Faris, JD
Chief Executive Officer

Posted in OMCA