Thursday, December 30, 2004

This Job Could Really be Fun...
If some patients weren't such a pain. My latest example. I performed an aspiration of a breast cyst last week. It had the appearance of normal cyst fluid, but the patient was insistent about it being sent off for cytology. I asked the patient to return in a week to discuss the results.
When the day of the appointment came, the patient refused to pay the co-pay required by her insurance company. She then called several times demanding we give her the results over the telephone. She was told by my staff that it was my policy not to give biopsy results over the telephone. She asked that we fax the results to her referring physician's office. We did that but the physician in question declined to give her the results.
The next day she began calling again. She became increasingly rude to my staff and even threw the threat of litigation around. She demanded her records and they were provided for her. The cost of copying the records was slightly less than her co-pay. I sent her a dismissal letter today.
Now before I am accused of being a money-grubbing heartless bastard, let me get a few things out:
I don't give results out over the phone because I don't think it's right to tell someone they have cancer over the telephone. Why not just give negative results over the phone? Firstly it's not fair to those with cancer that they are kept in suspense and secondly the discussion of results gets the patient back into the office for a wound check. Oftentimes follow-up mammograms need to be ordered and if the patients get what they want (the biopsy report) they will often "skip out" on the follow-up appointment. I'm sure that my primary care colleagues have similar problems with discussion of lab results.
The procedure done on this patient had no global period, and my practice is required by the managed care contract to collect the co-pay. Even if we don't the patient will get the bill for the co-pay from their insurance carrier.
Sometimes it's not worth the trouble...
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