<p>Well, people probably expect to be given a prescription because that’s usually what happens. And, who cares what they expect? If antibiotics and adderall and prozac are over-prescribed you can’t really blame the patients.This goes way beyond perceived rudeness and long waits, though. </p>
<p>Read the pdf. Patients expect/want a prescription. Its an interesting study, discussing the effects of direct target advertising to consumers… Its an old study by now, but it was put out by the Dept of Health and Human Services.</p>
<p>I believe you but that is not a good reason to give it to them.imho.</p>
<p>Not saying they do give them, actingmt. But there is an expectation that they will walk out with one. Many were for refills or for a condition they thought or knew they had. But its an interesting observation on expectations in treatment. Those who prefer homeopathic care or use netipots to address sinus problems may seeing different types of practitioners (just a thought).</p>
<p>Not long ago, I was in a room in the Emergency Room. A patient was really upset that doc wouldn’t write her a prescription for her pain med. Security was called in to calm her down.</p>
<p>Another risk of emergency medicine is that of meds seeking patients whose medical history is not available to them. Not saying that was the case int his patient’s case in this ER, but it happens a lot. </p>
<p>And one thought that I meant to mention earlier- just because a Dr neglected to apologize for the timeliness of the visit does not mean that they think their time is more valuable than their patient’s. That is a baseless assumption. Just because one poster threw down the gauntlet to Drs to defend themselves against her haughty assumption doesnt make it so. In fact, seems perhaps more likely that the reverse is true about who thinks their time is more valuable… And its certainly likely that the attorney is paid more per hour than the poor treating physician!</p>
<p>So I just found a doctors bill, to ensure I wasn’t talking out of my you know what about what they bill for a visit. I found one current bill for me, and for my husband (he goes to the same practice, different doctor). Both of them bill $269 for an office visit, they discount it a little for the insurance company, and end up getting $221.53 for the visit, so not too far off. It sounds like that’s way higher than the norm.</p>
<p>And even for that price, I still don’t want my doctor’s cellphone. They do encourage, send and answer emails pretty quickly. Nag, nag, nag. Get that colonoscopy. Blah. Though I wouldn’t mind my concierge doctors cell phone, not for questions, but to ask her over for dinner. I like her a lot.</p>
<p>What procedure code did they use? And is the 221.53 the insurance allowable for this visit/procedure code or doe it include your copay?</p>
<p>Sending CV!</p>
<p>I don’t see a procedure code on the bill. Maybe I’m blind. It just has a claim number and sequence number, type of service “office visit”. The insurance pays them $201.53 and we pay $20. But all doctors don’t have to be paid the same, do they? Can’t they charge whatever they like, and the insurance company works out some sort of deal with them? I’m glad I don’t have to pay it. I probably wouldn’t go very often if I did.</p>
<p>There are agreed upon “E&M” codes for visits (can be listed as a procedure code, but mostly involve cognitive stuff or thinking; not what I consider a procedure), with numbers like 96211, 99212, 99213,99214. How much they are reimbursed by insurance companies can be negotiated, and presumably varies with specialty. “Procedures” (like endoscopy) can be a whole different thing.</p>
<p>The Is your provider in individual practice or in a group practice? As was mentioned above, the insurance companies typically have a standard fee schedule they’ve come up with that is sent to providers who are interested in being on their panel. Its typically, though not always, a “take it or leave it” contract. In some cases (specialty type, location, etc) the provider may be able to negotiate the rates. In bigger group practices/hospitals the administration contracts with the insurer and negotiates the contract rates for the providers.</p>
<p>I don’t think they put the procedure code on the copy of the explanation of benefits that we get from the insurance company. I think both of our visits were for standard sick visits, like sinus issue and the like.</p>
<p>“One” can sometimes negotiate rates for “E&M”, which often amounts to managing risks and and benefits of various labs, tests, and meds, but “a friend mine” was offered $10 for adding on therapy…rumor has it…one is generally forbidden from discussing rates. </p>
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<p>
[QUOTE]
"You Don’t Think Patients are Customers. They do.</p>
<p>Are patients customers?</p>
<p>This follows the trend over the last decade or so to relabel patients as customers with the C-word showing up in hospital promotional materials as well as internal memos.</p>
<p>Many clinicians are, unsurprisingly, opposed to this.</p>
<p>“Patients aren’t customers,” they say, because calling a patient a customer transforms the patient i.e. an individual who lies waiting to be healed by the tender mercies of gentle yet firm clinicians, into a customer i.e. someone who is buying the services of the clinician and whose every demand needs to be met satisfactorily to ensure the prosperity of the clinician.</p>
<p>You can see how this power shift can happen simply by swapping labels.</p>
<p>As a result, many clinicians have taken a firm stance against patients being considered customers, to the chagrin of hospital managers worldwide. Unfortunately, it doesn’t really matter what the clinicians or the managers think about this issue.</p>
<p>What is paramount is how the patients see themselves.</p>
<p>And patients today see themselves as customers."</p>
<p>– Marc Cheong, pharmacist, PhD candidate, University of Lancaster, <a href=“http://happierhealthcare.com/2013/04/18/you-dont-think-patients-are-customers-they-do/[/QUOTE\”>http://happierhealthcare.com/2013/04/18/you-dont-think-patients-are-customers-they-do/[/QUOTE</a></p>
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<p>That happens every night in the ER of a hospital I used to work in. </p>
<p>“One” can sometimes negotiate rates for “E&M”, which often amounts to managing risks and and benefits of various labs, tests, and meds, but “a friend mine” was offered $10 for adding on therapy…rumor has it…one is generally forbidden from discussing rates."</p>
<p>The lab charges at this clinic look very low, so maybe that’s how they work it out. I wonder why one would be forbidden from discussing rates, who has the right to demand that?</p>
<p>ausinmshauri,
Your link doesnt work, but a little repair reveals that that person’s website or blog or whatever seems ot be based in Malasia, written by: <a href=“http://happierhealthcare.com/about-mark/”>http://happierhealthcare.com/about-mark/</a></p>
<p>Of course healthcare includes a customer service component. If every patient felt like the op, the dr wouldnt have any patients. There are lots of providers around. But, in reality, if the “customer” is the one paying the lions share of the bill (and not just the copay) THAT is the insurance co. At least thats true for healthcare in the US, which is what most of us are discussing, not healthcare in Malaysia.</p>
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<p>Well I KNOW who pays the bills - the patient. Who pays for the insurance?: either the patient, or the employer as a part of the patient’s compensation. Any way round the patient, as customer, is paying AND demanding better service.</p>
<p>Discussing charges and billing rates amongst doctors is considered a violation of government antitrust laws.</p>