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Old 07-12-2011, 10:54 AM
Location: Georgia, USA
28,163 posts, read 31,590,127 times
Reputation: 35170


Originally Posted by jtur88 View Post
Several months ago, I had an accident that required stitches. The doctor who put them in did not charge me to take them out. That was included in the original fee, even though it took a return trip for a second office visit.
Surgical procedures are reimbursed differently. The follow up visits are bundled into the payment for the surgery. This is an apples and oranges comparison.

Similarly, an honest and conscientious doctor who charges me to order a blood test, does not charge me a second time to read it, and a third time to explain to me what it said, and a fourth time to prescribe medication for the condition. When a doctor prescribes a test, he is undertaking to follow up on that test. Imagine a doctors saying "Whoa, here's a result of that blood test---I didn't see that coming! I have to charge extra for this."
So now you are envisioning 4 visits instead of one or two? I do not believe I ever implied that. I stand by my position. The doc deserves to be compensated for his or her cognitive work. It is best medical practice to see the patient before ordering tests. If insurance will not reimburse for discussion of the results over the phone, then the doc is within his rights to ask the patient to come to the office.

I saw my internist yesterday. We discussed some issues I have been having, he examined me, ordered the blood work, and I left with an appointment for a follow up appointment. I would not have it any other way.

My gynecologist uses an automated system for patients to get Pap results. That is fine with me, too.

Just seems to me that you begrudge the doc wanting to be paid for what he does when your copay is the equivalent of dinner for two at Red Lobster. If you have a Medicare supplement, your copay may be zero.

I assure you an internist or family medicine doc is not reeling in millions from his practice.
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Old 07-12-2011, 12:40 PM
Location: Mostly in my head
19,867 posts, read 59,169,758 times
Reputation: 19226
Most of my doctors are with a large non-profit hospital system that has an online patient info site. I can check lab results myself and my doctor can send me notes about them. Sometimes it's an "let's talk next visit," sometimes it's a "looks good" note.
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Old 07-12-2011, 09:39 PM
Location: not new to houston anymore
276 posts, read 768,687 times
Reputation: 252
some doctors do what you describe. many will send you a letter with your results but ask you to come back to discuss abnormals (especially if you went in for a physical but then the lab comes back with high cholesterol or something). the latter is normal practice. if you haven't seen the dr in 1 year, most of them will not just give you lab orders before your visit. the scenario in the OP sounds like a pain. everyone should be fair--the doctor and the patient. The doctor should definitely get paid for what he/she is doing and the patient shouldn't have to come in for normal results IF they were just seen. the doctor should not be expected to call in antibiotics for something they haven't seen you for in the last month or so. if you expect that, you're asking the dr to forfeit the $ they would have made to see you, the time/staff they had to dedicate to answer your call, and the dr may likely be treating something that doesn't actually require an antibiotic.

people often expect more dedication (and going out of their way) from their drs than they expect from themselves in their own jobs. a doctor needs to do the medically right thing, but they dont have to go out of their way for you. and if they do (like some people are noting in the previous posts), then you should be happy and realize that your dr is being nice. hopefully it is a mutually respectful relationship. you could also get that kind of treatment in a concierge practice (where you pay $$$ every year to be a patient in a very small practice--you have more direct access to the dr and the dr will bend over backwards for you)--but that is not the usual practice type.
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Old 07-13-2011, 11:07 AM
Location: Victoria TX
42,661 posts, read 77,707,464 times
Reputation: 36291
The responses seem to be drifting off the original question. Let's imagine the scenario:

I get an appointment with my doctor. He says "Why are you here?" I reply "Because you told me to see you "as needed" and to monitor my cholesterol." He replies "OK, take this slip to the lab, and by the way, give the receptionist $100 when you go out the door. If the results are not normal, schedule another appointment, and bring another $100. Do you have any other symptoms or is anything else bothering you? No? OK, have a nice day. Continue to see me "as needed"."

Imagine a doctor saying to a mother, complaining of a sick child, "Take his temperature, and then make an appointment to come and tell me what his temperature is. If it's too high, I'll recommend treatment." Some test results are so clear-cut that the patient can be depended on to look at the numbers, and determine if they are within normal range. Cholesterol is one of them. If you have a blood pressure machine at home, are you going to phone your doctor every day after taking your reading and say "Is that OK"? Should you need to make an appointment to see your doctor, to be given medical authorization to have your blood pressure checked?

Last edited by jtur88; 07-13-2011 at 11:22 AM..
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Old 07-13-2011, 11:22 AM
Location: Mostly in my head
19,867 posts, read 59,169,758 times
Reputation: 19226
I think we have beaten this topic to death. Your scenario is not 'real life" for many people. Thread closed.
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