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Old 2013-03-27, 14:21   #1
R.D. Silverman
 
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Nov 2003

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Default Patient Rights

A bit of a rant.......


I was initially referred by my PCP to a hematologist/oncologist
at my local community hospital when some routine blood tests
showed an elevated leukocyte level.

The oncologist made a preliminary diagnosis of either Chronic
Lymphocytic Leukemia or of Mantle Cell Lymphoma. Genetic
testing confirmed the latter and she ordered a PET scan.

I informed her that I would be transferring my care to Dana Farber
Hospital in Boston and that my results should be sent there.

Following the PET scan a radiologist (new doctor) read the results.

I was not informed that another doctor was being brought onto
the case. (the radiologist). My oncologist did not tell me that she
would not be reviewing the PET scan. She did not get my consent
to bring in another doctor. If she had asked I would have reminded
her that I was transferring my care.

Susequently I received a bill for $385.00 from the radiologist for
reviewing the PET scan. I am refusing to pay this. Even with insurance
the co-pay is substantial. Apparently, bringing in a radiologist is
'standard practice'. Is an oncologist not competent to check a
PET scan for tumors? If I had any idea that the oncologist was that
incomptent I would have never seen her in the first place!!!

Note also, that the PET scan itself was over $3000. (!!!!) My insurance
covered 80%.

What rights do patients have? I thought that informed consent was
required before any new doctor was brought in? Can a doctor just
bring in a radiologist without either telling the patient or getting
consent? And this was AFTER I said that I was transferring my care.

It's no wonder that health costs are out of control in the U.S.

BTW, my chemotherapy starts tomorrow.
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Old 2013-03-27, 14:53   #2
literka
 
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The most important for you now it is to get healthy again.
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Old 2013-03-27, 16:11   #3
LaurV
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Quote:
Originally Posted by literka View Post
The most important for you now it is to get healthy again.
+1! Fcuk the money! Get well soon! And stay well! That's prime! The rest are small factors.
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Old 2013-03-27, 16:21   #4
rogue
 
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Apr 2003
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Sounds familiar to what happened to us. My younger son broke his wrist a couple of years ago. My wife too him to a clinic that was in our health care network and they took an x-ray. A doctor spent 10 seconds looking at the x-ray and confirmed the break (as if we didn't already know). What we didn't know was the the doctor himself was not in our network and we got nailed for $200 for the 10 seconds he looked at the x-ray. I don't know if there was anything we could have done, but my wife and I were both angry that our insurance refused to pay it. How were we to know? Were we supposed to ask the doctor if he was in our network? Was the doctor supposed to tell us that he was out of network? If there were no other doctors at the clinic who could do his job, what choice did we have? Are we supposed to verify that every person in the clinic that touches our son in any way has to be "in network"? That is ridiculous.

As much as I am not a fan of a "single payer" system, this wouldn't happen in such a system. Although I agree in principle with a free-market approach to health care, this makes it very difficult for people to control their own health care costs.
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Old 2013-03-27, 17:14   #5
Fusion_power
 
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Aug 2003
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One, and only one, time this worked the way it should. My daughter fell from about 12 feet high and sprained her wrist. An x-ray was taken and screened at the time but was judged to show no damage to the bones. The next day, a radiologist reviewed the x-ray and immediately contacted me to tell me to get her back to the doctor because he spotted a small buckle fracture in her wrist. The potential was high for long term damage if it was not cared for. She had to wear a splint for a few weeks until it healed.

This obviously does not fit the circumstances above. It shows that there is a legitimate reason for second opinions on x-rays. It also shows that doctors can miss obvious problems. Once the radiologist pointed out the problem, it was easily seen.

I don't think there is any hospital in the U.S. where you can be given an x-ray without also getting that second opinion.

DarJones

Last fiddled with by Fusion_power on 2013-03-27 at 17:16
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Old 2013-03-27, 19:57   #6
Xyzzy
 
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Aug 2002

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Quote:
I don't think there is any hospital in the U.S. where you can be given an x-ray without also getting that second opinion.
We were feeling really rough one time so we went to the doctor. He told us that we had the flu. We told him we wanted a second opinion. He then told us we had syphilis.

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Old 2013-03-27, 20:45   #7
science_man_88
 
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Quote:
Originally Posted by R.D. Silverman View Post
A bit of a rant.......


I was initially referred by my PCP to a hematologist/oncologist
at my local community hospital when some routine blood tests
showed an elevated leukocyte level.

The oncologist made a preliminary diagnosis of either Chronic
Lymphocytic Leukemia or of Mantle Cell Lymphoma. Genetic
testing confirmed the latter and she ordered a PET scan.

I informed her that I would be transferring my care to Dana Farber
Hospital in Boston and that my results should be sent there.

Following the PET scan a radiologist (new doctor) read the results.

I was not informed that another doctor was being brought onto
the case. (the radiologist). My oncologist did not tell me that she
would not be reviewing the PET scan. She did not get my consent
to bring in another doctor. If she had asked I would have reminded
her that I was transferring my care.

Susequently I received a bill for $385.00 from the radiologist for
reviewing the PET scan. I am refusing to pay this. Even with insurance
the co-pay is substantial. Apparently, bringing in a radiologist is
'standard practice'. Is an oncologist not competent to check a
PET scan for tumors? If I had any idea that the oncologist was that
incomptent I would have never seen her in the first place!!!

Note also, that the PET scan itself was over $3000. (!!!!) My insurance
covered 80%.

What rights do patients have? I thought that informed consent was
required before any new doctor was brought in? Can a doctor just
bring in a radiologist without either telling the patient or getting
consent? And this was AFTER I said that I was transferring my care.

It's no wonder that health costs are out of control in the U.S.

BTW, my chemotherapy starts tomorrow.
a quick search finds:
Quote:
Originally Posted by [URL
http://www.nlm.nih.gov/medlineplus/patientrights.html[/URL]]
As a patient, you have certain rights. Some are guaranteed by federal law, such as the right to get a copy of your medical records, and the right to keep them private. Many states have additional laws protecting patients, and healthcare facilities often have a patient bill of rights.
An important patient right is informed consent. This means that if you need a treatment, your health care provider should give you the information you need to make a decision.
Many hospitals have patient advocates who can help you if you have problems. Many states have an ombudsman office for problems with long term care. Your state's department of health may also be able to help.
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Old 2013-03-27, 22:33   #8
ewmayer
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Bob, you should read some of Karl Denninger's (http://market-ticker.org/) rants about "stealth pricing" abuses in the healthcare "industry". He's been writing on the topic 1-2x weekly for the past year ... just avert your eyes from his "we need more guns in schools" rants and click back through a couple weeks' postings to look for the Medcare ones. It's appalling what goes on - some of it flagrantly illegal, but much alas legalized by way of a special antitrust exemption enjoyed by the industry. Indeed, if people paid as-they-went for this stuff as they do for other retail commodities, they would demand up-front disclosure of diagnostic & treatment options and costs, and healthcare spending would plunge. I realize that we need some form of mutual risk management for catastrophic-but-relatively-rare events (the original purpose of "insurance", before it morphed into a routine-care-at-ever-more-egregious-prices deal), but the current system is simply beyond broken.

Best wishes for your upcoming treatment - your personal feel-like-crap-o-meter will likely be in "major suck" territory no matter what, but hopefully chemo has improved in term of the benefit/side-effect ratio from a couple decades ago.

Last fiddled with by ewmayer on 2013-03-27 at 22:34 Reason: fix link
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Old 2013-03-28, 00:29   #9
Uncwilly
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Quote:
Originally Posted by R.D. Silverman View Post
Susequently I received a bill for $385.00 from the radiologist for reviewing the PET scan. I am refusing to pay this. Even with insurance the co-pay is substantial. Apparently, bringing in a radiologist is 'standard practice'. Is an oncologist not competent to check a PET scan for tumors? If I had any idea that the oncologist was that incomptent I would have never seen her in the first place!!!
A friend of mine (actually the husband of a friend) is routinely brought in to read various scans (x-ray and others). He is better at it than other doctors and has saved patients from unneeded procedures. He is so good at it that there are several hospitals that have him read scans. His bread and butter is a type of radiologically guided surgery. The oncologist is not going to be the whole team that is treating you. I can understand your frustration with various fees and charges, but like the others have said, it is more important that you get great treatment and get better than have a fancier funeral.
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Old 2013-03-28, 02:11   #10
NBtarheel_33
 
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Jul 2008
Maryland, USA

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May this be the first step in a completely successful journey. Good luck, God bless, and take care.

Re: health care and $$$ - better off bankrupt, sued, or with a negative credit report than dead or suffering. Money comes and goes, but health and lives are irreplaceable.
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Old 2013-03-28, 02:32   #11
ewmayer
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Quote:
Originally Posted by NBtarheel_33 View Post
Re: health care and $$$ - better off bankrupt, sued, or with a negative credit report than dead or suffering.
Perhaps, but should those be the only options? Whatever happened to "decent care at a decent cost?" It is objectively true that in the US we spend 2x more per person on healthcare than the next-nearest country, which IIRC is currently Switzerland. Are the Swiss less well-cared for?
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