Think reimbursement doesn’t matter? Consider this doctor who perhaps was too idealistic to practice in today’s harsh realities facing medical practice:

His malpractice insurance rates also spiked – from $5,000 the first year to $22,000. He hadn’t realized that more patients meant more risk for the insurance company. When Masewic saw the size of his rate increase, he had to take out a personal loan to pay it.

Every day for the last two months, Masewic or Danielle Devol, his practice manager, dive for the mailbox after the mail is delivered, hoping that there will be enough checks in the mail to cover the next round of bills.

“I come here every Saturday to see if I have any money,” Masewic said, “to see if I’m going to be in business next week.”

A few weeks ago, when he couldn’t pay his malpractice bill, he realized that it was time to close.

Masewic said he’s worked 70 to 80 hour weeks for the last two years and spent most nights and weekends on call for emergencies. But he said he never was able to pay himself enough to make a dent in his student loans or to even buy a car. He drives a rusty maroon Chevrolet Celebrity station wagon with 170,000 miles on it. When one self-pay customer saw Masewic’s car, he immediately paid a $500 bill that he’d been challenging, Masewic said.

For the last two months, Masewic has paid himself about $140 a week, which is all he has left after he pays his other bills.