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.