Checking fee schedules with patient in the room... unethical?

[ems2doc]

---

Members do not see this ad.

I was doing rotations with a PCP who I saw looking at physician reimbursement schedules on his smartphone with a patient in the room. Thoughts?

 

[Psai]

what he does is not your business

 

[DermViser]

Yes my thoughts are you are silly for divining intentions from a physician looking at reimbursement schedules on a smartphone. If he has a private practice, he has to be cognizant of these type of things, esp. in coding correctly, or his practice manager will tear him a new one.

 

[ems2doc]

Well that's just one aspect. There's also the fact that he's on his phone while with a patient. Whether an ethical issue or not, it just doesn't seem that polite. If I were trying to explain something to my PCP I wouldn't want him staring at his phone.

 

[DermViser]

Well that's just one aspect. There's also the fact that he's on his phone while with a patient. Whether an ethical issue or not, it just doesn't seem that polite. If I were trying to explain something to my PCP I wouldn't want him staring at his phone.

You're right bc it's not like you can talk to a patient and be on your smartphone or iPad at the same time. Is it any different than a doctor typing his note into his EMR in the patient room so that he can be properly reimbursed while not giving his patient his full undivided attention when he has tons of other patients in the waiting room? Grow up and get off your high horse.

 

[DrBowtie]

Was it a procedure that he doesn't do often?

I can tell you how many RVUs the 10 most common things I do are worth.

 

[DarknightX]

Rude? Maybe.

Unethical? Please enlighten me, what exactly is unethical about it?

 

[Kaustikos]

Since medicine is a business... I don't find fault. It'd only be questionable if a surgeon did it right before incision and was all "woah, wait! I can't make my Porsche payments with this reimbursement! Wake em up"
Never mind how he used his phone in a sterile field.

 

[KnuxNole]

Well that's just one aspect. There's also the fact that he's on his phone while with a patient. Whether an ethical issue or not, it just doesn't seem that polite. If I were trying to explain something to my PCP I wouldn't want him staring at his phone.

I go on my phone to check med dosage when talking about which medicine to start, or when they are trying to tell me what medicine they are, I quickly look on Epocrates.

Especially in this generation, it's very common. Hell, there are LOTS of docs who patients wrongly complain they "stare at the Ipad/computer the whole time". They are still actively listening to what the patient is saying, and trying to document all the stuff while doing so. I at least try to make eye contact.

 

[Kaustikos]

I go on my phone to check med dosage when talking about which medicine to start, or when they are trying to tell me what medicine they are, I quickly look on Epocrates.

Especially in this generation, it's very common. Hell, there are LOTS of docs who patients wrongly complain they "stare at the Ipad/computer the whole time". They are still actively listening to what the patient is saying, and trying to document all the stuff while doing so. I at least try to make eye contact.

I just draw pictures on my tablet while looking at them intently with concern. Am I doing it right?

 

[KnuxNole]

I just draw pictures on my tablet while looking at them intently with concern. Am I doing it right?

Well, your pictures are worth just as much as your regular student note in the eyes of the attending...maybe even more if the picture is good! 😛

 

[Ismet]

I was doing rotations with a PCP who I saw looking at physician reimbursement schedules on his smartphone with a patient in the room. Thoughts?

Nothing is unethical about this scenario.

 

[Megalomis]

I was doing rotations with a PCP who I saw looking at physician reimbursement schedules on his smartphone with a patient in the room. Thoughts?

Whoa..unethical? How so..I don't get it. I'm going to say no lol.

So this story is slightly off topic...but a few years ago I had to go see a neurologist (I was the patient). I can't recall exactly what we were talking about, but at some point during the visit he pulled up Wikipedia on his computer lol. At the time while we were talking I had no idea what he was reading until he directed the screen towards me. I will never forget that moment haha. I have to say that 1. I loved how he was willing to confidently admit that he didn't know the answer to whatever crazy question I had asked, and 2. That he was confident enough to use wiki as his source of information lol.

I think I'm reminded of this story tho bc I'm imagining this particular doc of yours on his cell while talking to a patient..and honestly, I'm going to say that for me and probably 99% of people out there, that's not a big deal at all. Just bc he was looking at reimbursement stuff on his phone doesn't mean he wasn't processing what the patient was saying. (Or that the patient felt that way either).

And as far as it being unethical, I'm not really sure what to say to that. Let the doc do his job? That's all I've got for ya lol.

 

[ems2doc]

You can check codes without looking at the fee schedule.

 

[Megalomis]

Ok you're right and he's wrong. I give up lol.

 

[DarknightX]

You can check codes without looking at the fee schedule.

Still didn't answer the question. What exactly is unethical about his behavior?

 

[Winged Scapula]

I'm not actually sure of the purpose for checking fee schedules.

Sometimes with cash pay patients my staff will ask me what code I'll be using to bill them for. Maybe I'd have to look up the code but the only reason I would look up fee schedules would be in the situation of a cash pay patient, to quote them a price (since most do it based on a percentage of CMS rates).

So what is the OP claiming - that the physician was distracted and looked at fee schedules when he should have been talking to the patient, was looking up fee schedules to decide how much to charge the patient? Was he simply looking up the billing code and the app happened to include the fee schedules?

I see nothing unethical about charging patients for your services and there are reasons to look at fee schedules in front of patients although most would not (simply because there is no reason to in most cases).

 

[DarknightX]

When I was moonlighting at an urgent care during my research year, I'd have to look up the fees routinely for certain services. I would tell the patient,"Hold on, let me check how much this is going to cost you." Then I'd step out, check with the biller, and then come back in with the cost.

It's much more ethical to tell them up front how much a service will cost as opposed to doing a procedure/service and then shocking them with a huge bill at the end.

 

[Winged Scapula]

When I was moonlighting at an urgent care during my research year, I'd have to look up the fees routinely for certain services. I would tell the patient,"Hold on, let me check how much this is going to cost you." Then I'd step out, check with the biller, and then come back in with the cost.

It's much more ethical to tell them up front how much a service will cost as opposed to doing a procedure/service and then shocking them with a huge bill at the end.

There's definitely a role for checking fee schedules - it seemed like the OP was accusing the physician of checking them to see how much money he's going to make (or not make) and perhaps making management decisions based on that. As you note, many patients want to know how much their OOP contribution will be and there is definitely a role for checking that (especially for non-covered services).