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Re: U.S. Managed care:the cost of ethics From: art fougner, md (evsono@pipeline.com) Wed Mar 6 09:16:01 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Computer orders" Previous message: art fougner, md: "Re: grow your business rapidly" Zach - goes back to what i and many have said before - a doctor receives 45 mil per annum for denying care - and no one sees the conflict of interest. just my opinion - i could be wrong. art ps the powers that be are getting their way - med school admissions are down 4% for the last few years. early retirements are up. looks like we're takin care of that doctor glut. At Tue, 5 Mar 2002, Zach Newton wrote: > >Managed care health plans by contract force acceptance of claim payment in a >manner that unilaterally forces non-payment for services not defined. > >Example: laparoscopic sterilization. At surgery, mutiple endometriotic >implants observed on left uterosacral peritoneum. After sterilization, the >implants are excised, lasered or electrosurgically obliterated. A 20 minute >procedure takes 90 minutes. Claim for primary and secondary procedures >recognized only by primary claim, even with hard copy, op and path reports >attached. > >Alternative for surgeon: do sterilization. Schedule laparoscopy procedure >for surgical treatment of endometriosis at a nearby convenient date. > >This is abhorrent. The geniuses that populate managed care policy are >leveraging that ethical behavior will force the surgeon to do the right >thing for the patient and eat the denial. For the most part, that is what >happens. Time for a line in the sand. We are being raped. > >-- >Zach Newton >Z.B. Newton, III, M.D. >Atlanta/Gyn > -- art fougner, md ich bin ein New Yorker Next message: art fougner, md: "Re: Computer orders" Previous message: art fougner, md: "Re: grow your business rapidly"

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