He woke up from eye surgery with a gash on his forehead. What happened?

[Agast]

He woke up from eye surgery with a gash on his forehead. What happened?

And guess who got blamed…

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[Agast]

I bet someone dropped the scalpel on his head

 

[Dr. Rude]

The article didn’t mention the anesthesia reimbursement. Probably about $100.

 

[GassYous]

We sit there at the feet nowhere near the surgical site. What are these guys smoking

And yeah the anesthesiologist probably got around 100$ for this medicare case.

 

[nimbus]

1. Eye doctor is a dummy for saying what she said.

2. Keratomes are so fine that they are unlikely to cut through the eye drape. It’s described as a “small abrasion” so it’s possible that his skin tore while they were removing the adhesive drapes.

 

[DrOwnage]

This article is like one giant hyperbole

 

[Dr. Rude]

This article is like one giant hyperbole

Patient is a candidate for Douchasaurus Rex.
May he go blind in his other eye so that he doesn’t need to have cataract surgery on that one.

 

[teacher2md]

Am I reading this bill correctly? the ophthos get $1800 per case for these 15 min cataracts??

And the facility got $2800??

WTF?

 

[BLADEMDA]

Patients should fight back and refuse to pay such bills, Caplan advises. Likewise, doctors in such situations should be fully transparent about what occurred and why. Though some physicians may worry about the risk of a malpractice suit, studies have shown that a simple admission, combined with an apology, often extinguishes a patient's ire. Such apologies are required by professional ethics, and in some states they are required by law, as well.

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The guy paid $53 in total but still bitching because he had a skin tear which e called a "gash." The investigation will clearly show there was no significant injury. I am sure you all have seen or heard of skin tears from tape or the drapes. Over the years, there have been some very significant skin injuries from the adhesives.

 

[BLADEMDA]

Am I reading this bill correctly? the ophthos get $1800 per case for these 15 min cataracts??

And the facility got $2800??

WTF?

They "bill" for a lot but MEDICARE reduces the charges to the agreed upon rate. You can bill for $1200 but Medicare will only approve $100 for the anesthesia and you are not permitted to balance bill the patient beyond their Co-Pay of the allowable Medicare charge.

 

[DrOwnage]

Am I reading this bill correctly? the ophthos get $1800 per case for these 15 min cataracts??

And the facility got $2800??

WTF?

The Medicare fee schedule for both cataract billable codes is around 680 and 860 bucks, and that’s including overhead. Not sure exactly why this article is quoting more.

 

[BLADEMDA]

Am I reading this bill correctly? the ophthos get $1800 per case for these 15 min cataracts??

And the facility got $2800??

WTF?

$526 plus $130 from United Health care for the surgical portion. The facility fee is more profitable: $2377 plus $550=$2877

Total Surgical fee paid: $656
Total Facility Fee: $2877
Anesthesia fee: $100?
Copay: $54

(I didn't add the Copay money back into the fees paid but it's negligible at $54 total)

 

[coffeebythelake]

I guess this is what passes for journalism these days.

 

[teacher2md]

No wonder these surgicenters are so profitable.

How much does the consumable surgical equipment (Lense implant) cost?

 

[thinkorswim]

Am I reading this bill correctly? the ophthos get $1800 per case for these 15 min cataracts??

And the facility got $2800??

WTF?

It’s not that high. Medicare pays about $500 for cataract surgery these days. Also keep in mind ophthalmologists have a 50-60% overhead.

I can’t speak for the facility fees but it wouldn’t surprise me if that number were accurate.

 

[ucladoc2b]

This patient is a jerk. A small gash (probably from the drape) that healed in about three days warranting a police report and a medical board complaint ? That’s terrible

And the doctor yelling “don’t move” is standard in most cataract surgeries.

 

[coffeebythelake]

This patient is a jerk. A small gash (probably from the drape) that healed in about three days warranting a police report and a medical board complaint ? That’s terrible

And the doctor yelling “don’t move” is standard in most cataract surgeries.

Patient is either a jerk or an idiot.
But we know the big idiot is the one who wrote and published this trash article on npr

 

[ucladoc2b]

Patient is either a jerk or an idiot.
But we know the big idiot is the one who wrote and published this trash article on npr

Could be both. The article is clickbait (especially for KHN). Arthur Kaplan is usually pretty good. But he’s a bit out of his expertise with surgical injuries.

Still not over a POLICE report tho. And board complaint. Ridiculous.

 

[Dr. Rude]

This patient is a jerk. A small gash (probably from the drape) that healed in about three days warranting a police report and a medical board complaint ? That’s terrible

And the doctor yelling “don’t move” is standard in most cataract surgeries.

If a police officer yelled don’t move and the patient wound up with only a scrape, the officer would be disciplined for inadequate use of force.

 

[The Duck Knows]

What’s up with the double standard?

He thinks patients shouldn’t have to pay for any additional care required for preventable complications (which I agree with) but also thinks he shouldn’t have to pay for the initial services he received?

Honestly, with the number of abrasions and skin tears I’ve seen even when we get half a dozen people to help carefully move and position, I think it should be considered a risk of the anesthetic and procedure. I discuss it with all of my patients (after all, I’ve had more skin tears moving a patient prone to the spine table than I have had dental injuries and lip lacerations). The OR tables are designed for surgeon efficiency and not safety/comfort. Sharp metal around edge. Steep trendelenberg positions with robotic arms flying every which way.

A small abrasion on the forehead? I’ve seen worse injuries to circulating nurses who have to finish their shift.

 

[coffeebythelake]

Arthur Kaplan is usually pretty good. But he’s a bit out of his expertise with surgical injuries.

So why not seek an experts opinion on this, like that of an independent ophthalmologist and anesthesiologist to weigh in on what happened? Instead they have this article full of non sense. Anyone who knows sees the journalist and patient as clowns. But the lay public is probably swayed to outrage over poor care and lying doctors.

 

[Dr. Rude]

So why not seek an experts opinion on this, like that of an independent ophthalmologist and anesthesiologist to weigh in on what happened? Instead they have this article full of non sense. Anyone who knows sees the journalist and patient as clowns. But the lay public is probably swayed to outrage over poor care and lying doctors.

Arthur Caplan is an ass. I would describe him as a self appointed expert.

 

[deleted875186]

Insane article. Don’t mean to be insensitive, but patient trying to file a police report for this? Completely inappropriate and disgusting.

Trying to make sense of why the ophthalmologist would say “anesthesia incident”. Perhaps it was an eye block, and the anesthesiologist gave a bolus of propofol and patient was disinhibited. Has happened, and is why I never use any prop for any eye procedure.

That being said, ophthalmologist could have prevented this by simply explaining in more detail to the patient what happened in the postop visit.