Re: TAH Length of stay
From: art fougner, md (evsono@pipeline.com)
Tue Jan 15 21:26:10 2002
this issue suggests that it is not clear which one of the inmates is
running the asylum here. these situations make lawyers salivate.
just my opinion - i could be wrong.
art
At Tue, 15 Jan 2002, Jay Kulkin wrote:
>
>If it is medically necessary establish it in the medical record. Having just left the health plan side I can't tell you how many times the nurses notes say the patient is fine and could leave at 5pm and the doc's notes says very little at 7am that same day. In addition, many docs make rounds earlier in the am when one would not expect a patient to look ready for d/c but by 5pm they are. This is what managed care plans look at. I do not under any circumstances understand a TAH being d/ced by guideline in 24 hours. I've seen a few patients request d/c this early but it sure is rare.
>
>Jay
>
>--
>Jay M. Kulkin, MD MBA FACOG
>Women's Health Resource Associates
>3475 Oak Valley Road
>Suite 2640
>Atlanta, Georgia 30326
>404-841-0034
>Fax: 404-841-0054
>
>>> ----- Original Message -----
> From: Gordon
> To: Multiple recipients of list OB-GYN-L
> Sent: Tuesday, January 15, 2002 10:43 PM
> Subject: Re: TAH Length of stay
>
> You are both wrong, the only one authorized to make the discharge decision is you and/or the patient. If she wishes to be discharged because of economic pressure from the hospital or insurance company, she will have to sign out AMA, unless you concur. The alternative is for her to dismiss you from her care and let the next physician sign her out.
>
> Gordon M. Goldman, M.D., FACOG
> Private Practice, St. Louis, Mo.
>
>>> ----- Original Message -----
> From: RModugno@aol.com
> To: Multiple recipients of list OB-GYN-L
> Sent: Tuesday, January 15, 2002 9:06 PM
> Subject: Re: TAH Length of stay
>
> In a message dated 1/15/02 9:53:05 PM Eastern Standard Time, evsono@pipeline.com writes:
>
> if you medically think this is unsafe then don't discharge - rather ask
> the insurance medical director to come write a note on the chart to that
> effect.
>
> They won't do that, but the UR nurse from the insurance company does!
>
> Robert Modugno MD MBA FACOG
> Marietta, GA
>
--
art fougner, md
ich bin ein New Yorker
