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View Poll Results: Would you
Decline to do the consult? 2 4.26%
See the patient and bill afterwards? 16 34.04%
See the patient and absorb the cost? 6 12.77%
Offer the patient the choice of having the consult and being billed, or not having the consult? 23 48.94%
Voters: 47. You may not vote on this poll

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What would you do?
Old 07-21-2009, 07:03 PM   #1
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What would you do?

Imagine you are a physician who is asked to consult on a patient. The problem is not life threatening, there is no diagnostic or therapeutic dilemma, and the main function of the consult is to provide information and support to the patient......who does not have insurance.
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Old 07-21-2009, 07:11 PM   #2
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How is asking me? A friend who is also a doctor? Someone off the street?

How much time and effort do you have to put into the consult? Will you be out cash or just your time?


IOW, I am an accountant... I get questions all the time about taxes etc... I will usually answer someone if it takes a minute or two... and tell them they need to do their own research as this is not 'official' from me... I would do the same if I was a doctor...
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Old 07-21-2009, 07:19 PM   #3
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It's a patient in a hospital. Not a friend or a relation.

A consultation requires your expertise. There is no cash outlay on your part. Just an hour or so of your time.
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Old 07-21-2009, 07:21 PM   #4
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All the medical offices I've been to require payment at time of service, for a new patient. Is that a possibility?
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Old 07-21-2009, 07:25 PM   #5
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The patient is in a hospital bed. Not likely to produce cash on the spot.
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Old 07-21-2009, 07:26 PM   #6
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I voted to see the patient and bill afterwards. As a physician, you want to help people, so do what you can. If you truly feel that the consult you provide will not help the patient, then make it short.

The patient (in the U.S., anyway) owes you the money whether or not he/she is insured. If he/she is poor, lower the fee as you see fit.

You DO have to earn a living - - I really do understand that. But you also have to sleep at night so I would at least see the patient briefly.
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Old 07-21-2009, 07:27 PM   #7
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I'd go with option # 4. If they want the consult, I would oblige and if it were not unethical, I'd probably give them a discount.
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Old 07-21-2009, 07:32 PM   #8
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Keep 'em coming!
When we have a good number of responses, I'll tell you what I did, and what my colleagues said they would do.
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Old 07-21-2009, 07:35 PM   #9
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Quote:
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Keep 'em coming!
When we have a good number of responses, I'll tell you what I did, and what my colleagues said they would do.
Will there be a prize for matching answers?
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Old 07-21-2009, 07:42 PM   #10
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Option 2 was my choice. If they recover and pay that is great. If they die, oh well. If they are truly indigent, you just helped a fellow human and your billing clerk writes it off. Or, if this is only for information and support, is there not a lesser skilled professional able to provide the service (Social Worker, Cancer Society Volunteer or Diabetes Foundation etc...)?
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Old 07-21-2009, 07:42 PM   #11
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Will there be a prize for matching answers?
A free consult!
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Old 07-21-2009, 07:43 PM   #12
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A free consult!
When will you be in Phoenix so I can schedule that?
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By the time I get to Phoenix....
Old 07-21-2009, 07:45 PM   #13
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By the time I get to Phoenix....

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Old 07-21-2009, 07:48 PM   #14
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Do you have options 2 and 4?

Edit to add:
Since your patients are kids (I think), can you live with yourself if you don't help?
Or is this just theoretical and not a part of you practice?
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Old 07-21-2009, 07:55 PM   #15
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I didn't vote as I think my answer would be "it depends." Once my dr. called in a colleague in her office to weigh in on a problem I was having as a courtesy. Another time she referred me to a (different) colleague in her office and that was a billed appointment.

But even if billlable, in the situation you describe, that is nice of you (or any doctor) to do.
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Old 07-21-2009, 08:14 PM   #16
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Dang - with the arrow over Glen's face i thought that was kd lang at first.

I voted offer consult after letting the patient know it would cost if they wanted the consult. As a mechanic in my own shop i did a lot of free consults - but they sure didn't take an hour! 5-10 minutes free, maybe 15 or 20 for a good customer or friend, but an hour? really? that has to include reading the whole chart, personal checkup, and some phone calls right? I don't think I've had a doctors undivided focused attention for an hour in ... ever? and free? Wait - this is a trick question - aren't you in Canada?
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Old 07-21-2009, 08:25 PM   #17
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Wait - this is a trick question - aren't you in Canada?
Yeah...but, but, but we were to imagine ourselves as a physician. Since I'm in the US, I had to go with that...

Calling Dr bbbamI!
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Old 07-21-2009, 08:27 PM   #18
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I voted to see the patient and bill afterwards. The most important thing is to take care of the person. If this were a situation requiring a large commitment of time and resources, perhaps more analysis would be required. Plus, no insurance does not necessarily mean no money. Furthermore, even if the patient has insurance this doesn't mean you would be getting paid a fair amount for your work.
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Old 07-21-2009, 09:28 PM   #19
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"See the patient and bill afterwards."

Or, as my eye doctor said, looking deeply into my eyes, "no insurance, so, this one's on you." His office has signs everywhere, something like, "pay on your way out."
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Old 07-21-2009, 10:58 PM   #20
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In my specialty, most pts I am asked to see have cancer, so I see the pt and prescribe therapy no matter what and don't even check ability to pay now or later.... I let my office worry about that. I am fortunate to be in a position to be able to do that, and no one will stop me from treating a patient for free. Now, if the problem was not life threatening..... and just for an opinion...... it would probably depend on how much time I had that day, or if I was doing it as a favor for a friend, etc... After all, as doctors, don't most give opinions and advice regularly to family, friends, friends of friends, barbers of friends of friends, etc....
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