Here’s How We Play
Listen, if you’re the plastic surgeon on-call, you’ve got to take the good with the bad. Usually this means that you have to take the occasional significant, plastic surgeon-only case (like tendon lacs or parotid duct injuries) in an uninsured patient. In return, you get a bunch of simple insured, elective lacerations that you can charge a bajillion dollars for.
New take on this is an insured patient with a significant, multilayer, facial laceration that theoretically I could close ( albeit probably with a suboptimal cosmetic result) who specifically requests a plastic surgeon but happens to be 90 years old. If you piss and moan and refuse this case, guess what? I’m going to call in another plastic surgeon who will gladly take it and make plenty of money off it. Guess what you’re getting for the rest of my shift? Uninsured lacs that “I just don’t feel comfortable closing”. Most likely after 11 PM.
Payback is a bitch.
Tuesday, October 16th 2012 at 12:25 am |
Whyinhell would you refuse the 90-year-old?
Tuesday, October 16th 2012 at 12:33 am |
Not a medical professional here, but my guess is that suturing most 90-year-old facial skin and underlying tissues is a bit like trying to suture damp Kleenex, and would be a colossal pain in the butt. Either that, or the 90-year-old may not be interested in any subsequent cosmetic procedures, hence would not be seen as a possible “revenue stream”…just guessing!
Tuesday, October 16th 2012 at 5:34 am |
You are right on some points. However, this was a completely active and with it patient who was very concerned about her appearance.
Tuesday, October 16th 2012 at 5:35 am |
He was lazy. Didn’t feel like coming on the weekend.
Wednesday, October 17th 2012 at 11:34 am |
90 year olds have Medicare as their insurance. The reimbursement from Medicare is not so great.
Friday, October 19th 2012 at 6:20 am |
She had a supplement. Regardless he didn’t want to be bothered.