Monday, December 15, 2008


Lest you believe that I am out of touch or that I cannot support the claims I make in this blog I have two "proofs" from the first hour of my work day.

While making rounds this morning a patient who delivered yesterday complained that her pediatrician of the past four years would not see her new baby until after discharge. "That is true," I explained to her as I also praised the very qualified "hospitalist" pediatrician who had already seen her newborn. Both of these physicians are employed by the hospital and with the division of labor one sees the "inpatients" and the other sees the "outpatients."

Secondly, I arrived at my office (I still go both places) to receive a call from one of the imagining centers where I send patients. "Dr. LMD, we have Ms. Smith, your patient here and she thinks that she has a broken foot." I remember Ms. Smith well since I delivered both her children. "We need an order for an X-ray."

"I can give you and order for an X-ray," I replied, "But who will treat the patient? I am an obstetrician-gynecologist."

"I know that but the orthopedic surgeon will not see the patient without the X-ray."

Allowing the X-ray I knew that it would be within my rights to make the patient come over to my office and see me first. After examining her foot, I could then collect a co-pay from the patient while filing a claim with her insurance company who requires my name on the order for the X-ray. The end result would be the same but it would have been more costly.

I did not have time to see this patient. I was seeing another patient who was just treated for pnuemonia. During her illness she had an abnormal laboratory test, ended up getting a total body CT scan where an abnormality was found in her pelvis. Though quite a distance from her lungs she was now getting her yearly gynecologic care.
addendumSocialTwist Tell-a-Friend

No comments: