Is it unethical to accommodate patients with better insurances more then those with say medicaid?

[PocketRocket]

I thought this was common sense. Obviously those that pay more money for their insurance or are private patients should be given better appointment availability. Their is no question that quality of care should remain the same regardless of who the patient is. But when it comes to the "luxury" of being seen at your convenience, the PPOs and the privates should be more readily accommodated, right? I saw a patient flip out today at the receptionist because she was told she can't have an appointment that another person booked right before her. I can tell this lady was super rude and disrespectful to the receptionist who then, out of annoyance, told her that it's because she has bad insurance. The rude lady gasped and kept going off about how wrong this is and unfair.
Is it?

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[deleted738762]

she was told she can't have an appointment that another person booked right before her.
Is it?

Hi PocketRocket-
I don't understand this statement and your logic. No one can get someone else's appointment they scheduled before you, so how does this relate to her bad insurance? Your logic would make sense if the person with the bad insurance had the prior appointment and then some person with better insurance took that appointment, hence the accommodation.

Nevertheless, the nature of this question has to do with money & not helping people. If I didn't know any better I would seek people out for their money or insurance. However, as being someone who had to wait 2-3 MONTHS to get a wisdom tooth extraction because of my insurance I know first hand how frustrating it can be. This question just boils down to money or genuinely wanting to help someone. It's hard to do the right thing and yes it's unethical no matter how hard you try justifying it to yourself (At least in my eyes). At the end of the day your a dentist not a stock broker. This leads into a question: How can dentists be dentists with a business aspect influencing them?

 

[PocketRocket]

Not sure exactly what happened but I think the better insurance person was given a weekend appointment while the other person wasn't. But what if it's a non-emergency appointment and the patients health and quality of life is not compromised by the wait? Is it still unethical to offer the sooner appointments to $$$ and have the Medicaid patients wait?

 

[deleted738762]

Not sure exactly what happened but I think the better insurance person was given a weekend appointment while the other person wasn't. But what if it's a non-emergency appointment and the patients health and quality of life is not compromised by the wait? Is it still unethical to offer the sooner appointments to $$$ and have the Medicaid patients wait?

Obviously in the real world ethics are twisted. We don't live in a world where ethic professors are right. However, if both patients had no symptoms of pain then I would prioritize the one with better insurance of course.

However, now their is a time factor, which you should be generous about. If that bad insurance patient (with no pain) called first and 20 other good insurance patients called after him then I wouldn't hold him back an extra week but maybe a 1-2 days. Obviously this depends on the ratio of bad insurance patients and good insurance patients and their pain levels. In the end every patient is a human who deserves respect and dignity. Not saying you don't portray those qualities to others of course, but just for argument's sake.

Also just for distinction, if bad insurance patient had any kind of pain and good insurance had no pain, then clearly I would prioritize bad insurance patient first.

 

[DrJeff]

You can instruct your staff in private practice to manage your schedule as you "ideally" want to

For example, my staff knows that my "ideal" schedule has no more than 2 kids in a row, weeks out my medicaid patients aren't booked into my "prime time" spots unless the visit has above a certain amount of production, etc, etc, etc

In reality though, because of changes to my schedule, typically within 48-72hrs of the scheduled appt time, my "ideal" scheduling template that my front desk is instructed to use, gets altered. That's just the way it is.

There is absolutely nothing technically wrong with giving preference to scheduling a certain type of patient in certain places in your schedule rather than others. Some people though may have ethical issues with that, and that's their own personal decision

 

[Silent Cool]

OP,

You'll have to make that call yourself:

https://www.washingtonpost.com/loca...e-is-on-mend/2012/02/15/gIQANEJoGR_story.html

http://www.pbs.org/wgbh/frontline/article/tragic-results-when-dental-care-is-out-of-reach/

http://www.politifact.com/florida/s...ng-toothache-really-could-potentially-kill-y/

 

[ncide]

Medicaid patients have low reimbursements and have a high no-show rate, so you usually schedule them with that in mind.