02/20/2017    

QUERIES (ETHICS)

Query: Ethical Dilemma

I was recently referred a 17 year old male who had been in a 4 wheeler accident 2 years prior, sustaining a compound fracture of his left lower leg. Over the last year, he has developed a symptomatic hallux hammertoe of the left foot. It appears that he needs a Jones teno-suspension with an arthrodesis of the left HIPJ. The patient has Amerigroup, and my reimbursement for this will be a grand total of $237. Considering my peri-operative time, along with the 90-day global, this will hardly be the $15 minimum wage. Here's the quandary: Perform the surgery? Decline to perform the procedure? How do my colleagues handle this "predicament", and what is your justification for your decision?

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02/24/2016    

QUERIES (ETHICS)

Query: To Bill or Not to Bill?

 

We had an unusual experience this morning. A new patient checked in, paid their co-pay, the medical assistants entered his medical information into the EHR, and he was roomed. At the very moment my medical assistant started to take the patient’s vital signs, the patient stated he suddenly could no longer lift his left arm. The MA came and got me immediately and I took one look at the patient and asked him to smile for me, revealing obvious left-sided facial droop. 

 

We called 911 and while we waited for EMS to arrive, I explained in detail what was happening and that treatment would likely require t-PA within the next 2-3 hours at the hospital. I did my best to keep the patient and his wife calm and we put together a ...

 

Editor's note: This extended-length query can be read here.