quackquack

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Are you allowed to treat family members? I know in Canada, you're not supposed to see your spouse because you are in a relationship with that person, but I can't find anything regarding seeing family members.

My question is that, is this frowned upon? The way I see it is that, as long as you are professional and unbiased then it's ok. But you can't ignore the fact that there may possibly be conflicts of interests.

A case to prove my point: two patients; one is a patient, one is your father. One patient is scheduled to see the OMD in a month. Your dad gets an appointment next week after you called in and scheduled the appointment yourself.

(This is a case study that I took from some ethical training for optometrists that I googled. Not making it up...)

Obviously the OD shouldn't have called in himself, if he regularly doesn't call him for his regular patients. But this whole situation could have been avoided altogether if he wasn't seeing his family members at all.

What do you guys think?
 

Meibomian SxN

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Are you allowed to treat family members? I know in Canada, you're not supposed to see your spouse because you are in a relationship with that person, but I can't find anything regarding seeing family members.

My question is that, is this frowned upon? The way I see it is that, as long as you are professional and unbiased then it's ok. But you can't ignore the fact that there may possibly be conflicts of interests.

A case to prove my point: two patients; one is a patient, one is your father. One patient is scheduled to see the OMD in a month. Your dad gets an appointment next week after you called in and scheduled the appointment yourself.

(This is a case study that I took from some ethical training for optometrists that I googled. Not making it up...)

Obviously the OD shouldn't have called in himself, if he regularly doesn't call him for his regular patients. But this whole situation could have been avoided altogether if he wasn't seeing his family members at all.

What do you guys think?
Here in the US we can examine, treat & prescribe to family members.
 

KHE

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Here in the US we can examine, treat & prescribe to family members.
Virtually every 3rd party payor that I am a provider for has language in their contracts specifically forbidding doctors billing for services to family members. You can see them, you're just not supposed to bill for them.
 

VA Hopeful Dr

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Virtually every 3rd party payor that I am a provider for has language in their contracts specifically forbidding doctors billing for services to family members. You can see them, you're just not supposed to bill for them.
I've often wondered something. I know this practice is quite common in optometry - my dad was my eye doctor for 22 years. Why then is it verboten for MDs to see immediate family?
 

KHE

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I've often wondered something. I know this practice is quite common in optometry - my dad was my eye doctor for 22 years. Why then is it verboten for MDs to see immediate family?
Well, from an ethical standpoint you're not supposed to see family members as an OD either because in theory, your judgement can be clouded but the nature of eye care is generally non emergent, non life threatening and not quite as intimate as other health care encounters....ie: you keep your clothes on.
 

stonegoat

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Well, from an ethical standpoint you're not supposed to see family members as an OD either because in theory, your judgement can be clouded but the nature of eye care is generally non emergent, non life threatening and not quite as intimate as other health care encounters....ie: you keep your clothes on.

Keep your clothes on?? Not in Canada! All my patients get naked, and then I take pictures of them and post them on the internet....all perfectly legal, and even encouraged in Canada.
 

Meibomian SxN

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Virtually every 3rd party payor that I am a provider for has language in their contracts specifically forbidding doctors billing for services to family members. You can see them, you're just not supposed to bill for them.
Yes it says that, but I have never seen them not pay; even though they have that right.
 
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quackquack

quackquack

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So you can see them but can't bill them? Isn't that providing free services? I can't imagine the other patients being too happy about that, because your family members are basically getting "a deal". Correct me if i'm misunderstanding this.
 

Meibomian SxN

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So you can see them but can't bill them? Isn't that providing free services? I can't imagine the other patients being too happy about that, because your family members are basically getting "a deal". Correct me if i'm misunderstanding this.
You can bill for services, KHE is saying that the insurance companies can also deny the payment if they want.

In personal experience I have never seen the services not get paid. But obviously doctors can easily start acting in fraud, hence the law rules.

The same can be said with medications; narcotics in particular.
 

KHE

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So you can see them but can't bill them? Isn't that providing free services? I can't imagine the other patients being too happy about that, because your family members are basically getting "a deal". Correct me if i'm misunderstanding this.
Are you kidding me? I think most patients would be MORE shocked to find you were NOT giving your family members some sort of deal.

You would actually charge your mom? lol
 

JMU07

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So you can see them but can't bill them? Isn't that providing free services? I can't imagine the other patients being too happy about that, because your family members are basically getting "a deal". Correct me if i'm misunderstanding this.
I'm pretty sure most docs give free exams to their immediate family. This isn't a weird thing. For example, my mom works at a doctor's office and all of their docs and staff get free yearly exams, plus their mothers and daughters (it's an OBGYN practice).
 

4Eyes

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The question is whether or not you'll WANT to see them. Some of them will want to talk about eye stuff every time you speak with one another. :p

This mostly true with moms and contact lenses. A resident-turned-faculty member told us this when I was a student, and I didn't heed her advice. Some days I wonder if I should have.... Hmm....

(This is mostly tongue-in-cheek...love my mom...and it's not every time we speak.... :laugh:)
 

physicslover

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lol i see this with my aunt. anytime she visits someone, everyone suddenly has a question about their eyes. and assumes you can connect them to free glasses, examinations etc.
 
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quackquack

quackquack

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No I mean, I know that docs give deals to families and relatives sometimes, but I mean from an ethical standpoint, should you? I'm not talking about from the standpoint of "what is being done". Like in Canada (which is where I am), what is being done is that docs see their spouse _all_ the time, but ethically, they're not supposed to - the associations even tell you to stop, the public doesn't like it etc.

I'm just wondering if the general public frowns upon this, or nobody really minds? Like if I was waiting for an appointment, and some guy just walks in and gets to see the doc right away, whereas I have been waiting for 30mins, I'm not exactly going to be thrilled. It's not about charging your mom or not... it's about "special treatment" and how this might look to your patients. Or I guess it's more of a "it's just how it goes" kind of thing? If Britney Spears is my friend she's not going to make me pay to go see her.

But if the "deal" is on eye glasses then I can kind of understand because it's on materials, not the service. My optometrist even told me that he gives deals on those, but he would strictly tell the staff that the deal/coupon/whatever applies to the glasses only, not on the actual service the optometrist gives.
 
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physicslover

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if you are seeing your spouse after-hours, i think it would be ok. if you make it known to patients tht you are bringing in ure family, it might seem a bit weird, i would do it on personal time, where people aren't staring, or don't make it obvious that it is your family that you are seeing.
 

KHE

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No I mean, I know that docs give deals to families and relatives sometimes, but I mean from an ethical standpoint, should you? I'm not talking about from the standpoint of "what is being done". Like in Canada (which is where I am), what is being done is that docs see their spouse _all_ the time, but ethically, they're not supposed to - the associations even tell you to stop, the public doesn't like it etc.

I'm just wondering if the general public frowns upon this, or nobody really minds? Like if I was waiting for an appointment, and some guy just walks in and gets to see the doc right away, whereas I have been waiting for 30mins, I'm not exactly going to be thrilled. It's not about charging your mom or not... it's about "special treatment" and how this might look to your patients. Or I guess it's more of a "it's just how it goes" kind of thing? If Britney Spears is my friend she's not going to make me pay to go see her.

But if the "deal" is on eye glasses then I can kind of understand because it's on materials, not the service. My optometrist even told me that he gives deals on those, but he would strictly tell the staff that the deal/coupon/whatever applies to the glasses only, not on the actual service the optometrist gives.
Again, I think just about any member of the public would be shocked to know that I charge my mom for care. As far as seeing my mom before someone else, I normally see my mom when my office is closed. lol
 

JMU07

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Yeah, I think it's just how it goes (as you said).

Here's another question. If you're seeing family (or friends, whoever) for no charge, can you still bill their insurance or is that illegal?
 

VA Hopeful Dr

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Yeah, I think it's just how it goes (as you said).

Here's another question. If you're seeing family (or friends, whoever) for no charge, can you still bill their insurance or is that illegal?
Illegal, if you get an insurance audit and they see that you've done that there will be problems.
 

VA Hopeful Dr

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Again, I think just about any member of the public would be shocked to know that I charge my mom for care. As far as seeing my mom before someone else, I normally see my mom when my office is closed. lol
That's how we did it, barring anything acute (FB, conjunctivitis an hour before I was supposed to start kindergarten).
 

KHE

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Yeah, I think it's just how it goes (as you said).

Here's another question. If you're seeing family (or friends, whoever) for no charge, can you still bill their insurance or is that illegal?
Well that's a double whammy because every insurance contract says:

1) You won't see family members
2) You won't waive copayments.

So in your example you've done both.
 

stonegoat

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I tell you, everytime I read one of these threads, it sure makes me glad I don't have to deal with the idiocy of insurance companies (yet....:cool:)
 

Dogod

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The college in Ontario deemed examining your spouse such an risk to public eyecare that the topic graced the cover of their latest bulletin :confused:. Taking the case of a chiropractor who married a woman he met as a patient, followed by an obviously messy divorce after only a few years of marriage and ensuing license suspension, the optometry college takes the view that it is illegal for ANY Ontario OD to examine their spouse.

http://www.collegeoptom.on.ca/contentmanager/XSL/cooWeb20/ObjectFile.aspx?sys-Portal=1&sys-Class=Document&sys-ID=88&sys-Attr=File

Is it any wonder Ontario still does not have TPA's?
 
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quackquack

quackquack

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Yeah you're not supposed to see your spouse (or at least, it's not recommended). I've read about that chiropractor case as well!

Thanks for all the great discussion guys! I like hearing different things. As for the insurance problems that surrounds optometry, can someone give me a quick break down of this? I don't really understand this very well, except how you can't get paid for the services you provide. If anyone is from Canada and can enlighten how this is different there, that would be awesome, as I can't find anything on this.
 

VA Hopeful Dr

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The college in Ontario deemed examining your spouse such an risk to public eyecare that the topic graced the cover of their latest bulletin :confused:. Taking the case of a chiropractor who married a woman he met as a patient, followed by an obviously messy divorce after only a few years of marriage and ensuing license suspension, the optometry college takes the view that it is illegal for ANY Ontario OD to examine their spouse.

http://www.collegeoptom.on.ca/contentmanager/XSL/cooWeb20/ObjectFile.aspx?sys-Portal=1&sys-Class=Document&sys-ID=88&sys-Attr=File

Is it any wonder Ontario still does not have TPA's?
The biggest problem in that chiro case was turning a patient into a personal relationship. That was point #1 in my "**** you can't do when you're a doctor" lecture.
 
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quackquack

quackquack

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Is there anything else that is considered a "personal relationship" aside from spousal relationship?