Charging patients who are co-workers (or their kids)

[SpongeBob DoctorPants]

What are your thoughts on billing for appointments when the patient is a co-worker (or a co-worker's child)? Do you provide free care, because they work with you everyday and you have a different relationship than you do with other patients? Or do you charge them as you would anyone else for your time and expertise?

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[clausewitz2]

What are your thoughts on billing for appointments when the patient is a co-worker (or a co-worker's child)? Do you provide free care, because they work with you everyday and you have a different relationship than you do with other patients? Or do you charge them as you would anyone else for your time and expertise?

I can't imagine treating anyone I ever intended to work with in the future. I know other specialties don't have a problem with this but unless their mental health challenges but are trivial it would make the working relationship deeply uncomfortable and asymmetric.

 

[WisNeuro]

I wouldn't do an neuropsych eval or therapy work with anyone that I worked with, or their family members. I'd tell them that I have several colleagues I can refer them to in the area that I trust.

 

[SpongeBob DoctorPants]

I appreciate the input. I agree with the idea of not treating co-workers (and I probably wouldn't as long as other options are available), but in my situation I have agreed to treat a co-worker's child. The child was previously treated by another psychiatrist in our clinic who used to work with us, but has since left the practice. Being the only child psychiatrist in the region, I was the natural choice for this young patient to see. Otherwise, the family would have to travel a few hours to the nearest big city to find the next child psychiatrist in the state.

 

[FlowRate]

I appreciate the input. I agree with the idea of not treating co-workers (and I probably wouldn't as long as other options are available), but in my situation I have agreed to treat a co-worker's child. The child was previously treated by another psychiatrist in our clinic who used to work with us, but has since left the practice. Being the only child psychiatrist in the region, I was the natural choice for this young patient to see. Otherwise, the family would have to travel a few hours to the nearest big city to find the next child psychiatrist in the state.

This is a "problem" common to less resourced settings. I'm only a resident, but my opinion is that you should absolutely charge for visits and try your best to maintain your usual treatment frame.

 

[deleted480308]

If it’s not part of a stated benefits package I would charge full rate. It’s already inconvenient that geographic isolation doesn’t really make it easy to refer them out, so I’d want them as “by the book” as possible

 

[TexasPhysician]

Your practice, your rules.

 

[Monocles]

$$$

 

[milesed]

I am forced to due to being in a smaller town. I work at a large CMHC and see about 5 adult co-workers and about 10 children of co-workers at any given time. I also see a lot of kids from families we socialize with. It's not an issue with boundaries most of the time and we do charge them the same. We all have insurance and we all want to keep our paychecks.

The only issue I run into is moms who want to talk about their kids' issues with my wife.