Comments on: An ER resident opens his eyes to defensive medicine http://www.kevinmd.com/blog/2007/03/er-resident-opens-his-eyes-to-defensive.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/03/er-resident-opens-his-eyes-to-defensive.html/comment-page-1#comment-72875 Anonymous Wed, 14 Mar 2007 22:48:00 +0000 http://clients.emmense.com/kevinmd/2007/03/an-er-resident-opens-his-eyes-to-defensive-medicine.html#comment-72875 Defensive medicine is a huge issue! Here's a great resource on it:<br/><br/><a HREF="http://www.doctordisability.com/residentblog.html" REL="nofollow">Resident Economics</a> Defensive medicine is a huge issue! Here’s a great resource on it:

Resident Economics

]]> By: Gasman http://www.kevinmd.com/blog/2007/03/er-resident-opens-his-eyes-to-defensive.html/comment-page-1#comment-72503 Gasman Mon, 05 Mar 2007 14:29:00 +0000 http://clients.emmense.com/kevinmd/2007/03/an-er-resident-opens-his-eyes-to-defensive-medicine.html#comment-72503 Must also consider simple economics. <br/>My hospital's ER does not bill professional services of the docs; they take a salary from the hospital and the hospital pays out of its general funds. This model allows ER staffing not to accomodate at all times medical direction rules (otherwise enforced by the payor, medicare) and shed the cost of collection (from a population that is 50% non-collectable anyway). <br/>Referral to the specialists is the means by which revenues are generated for other departments of the academic physician group and creates billable procedures (MRI, CT, echo etc.) for the hospital. <br/><br/>Referrals are the lifeblood of the economics of my ER. Too bad if the ER residents are merely gatekeepers, but the economic plan rules. Must also consider simple economics.
My hospital’s ER does not bill professional services of the docs; they take a salary from the hospital and the hospital pays out of its general funds. This model allows ER staffing not to accomodate at all times medical direction rules (otherwise enforced by the payor, medicare) and shed the cost of collection (from a population that is 50% non-collectable anyway).
Referral to the specialists is the means by which revenues are generated for other departments of the academic physician group and creates billable procedures (MRI, CT, echo etc.) for the hospital.

Referrals are the lifeblood of the economics of my ER. Too bad if the ER residents are merely gatekeepers, but the economic plan rules.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/03/er-resident-opens-his-eyes-to-defensive.html/comment-page-1#comment-72500 Anonymous Mon, 05 Mar 2007 12:56:00 +0000 http://clients.emmense.com/kevinmd/2007/03/an-er-resident-opens-his-eyes-to-defensive-medicine.html#comment-72500 I know that it must be frustrating for the resident who wants to do much, but his/her attendings may be teaching an important lesson. The ER docs are often the target of lawsuits in which the first thing the attorney will state is why didn't you call a specialist. In one case, a facial laceration was repaired in the ER. The patient then sued claiming he had permanent nerve damage and pain as a result of the repair. The inusrance carrier payed a settlement out of court. (The nerve injury was from the fact that the infraorbital nerve was severed in the original injury). Would the patient still have sued if a specialist was called? Most likely, although it would have been the specialist that was sued.<br/><br/>Chris I know that it must be frustrating for the resident who wants to do much, but his/her attendings may be teaching an important lesson. The ER docs are often the target of lawsuits in which the first thing the attorney will state is why didn’t you call a specialist. In one case, a facial laceration was repaired in the ER. The patient then sued claiming he had permanent nerve damage and pain as a result of the repair. The inusrance carrier payed a settlement out of court. (The nerve injury was from the fact that the infraorbital nerve was severed in the original injury). Would the patient still have sued if a specialist was called? Most likely, although it would have been the specialist that was sued.

Chris

]]> By: Anonymous http://www.kevinmd.com/blog/2007/03/er-resident-opens-his-eyes-to-defensive.html/comment-page-1#comment-72493 Anonymous Mon, 05 Mar 2007 03:31:00 +0000 http://clients.emmense.com/kevinmd/2007/03/an-er-resident-opens-his-eyes-to-defensive-medicine.html#comment-72493 Kevin, while it's clear you have only a single horse to beat, you do realize that nothing in that thread even remotely addresses defensive medicine, right?<br/><br/>I mean, unless you've made a post there in the last few seconds. Kevin, while it’s clear you have only a single horse to beat, you do realize that nothing in that thread even remotely addresses defensive medicine, right?

I mean, unless you’ve made a post there in the last few seconds.

]]>