Saturday, August 25, 2012

A Slippery Slope

Dr. Sisk shifted uncomfortably in his chair.  He stared at the computer screen in front of him as he once again tried to plead with the elderly woman and her husband sitting quietly in the exam room.  The treatment being offered was futile.  The cancer had spread to too many organs. It was time to consider hospice.

The couple listened patiently but again expressed their wish to continue forward.  If the oncologist was offering, they were taking.  They weren't quitters after all. Dr. Sisk took another deep exasperated breath.  He wiped the sweat from his forehead before speaking. 

Well then, I'm going to have to ask you to find another doctor.

He looked down as he said the words.  He couldn't bare to peer into the eyes of the grandmotherly figure sitting in front of him. But, he felt he had no choice.  The chemotherapy cycle called for new injections every two weeks. No doubt, debilitated as she was, she would land in the hospital shortly thereafter.That would mean two admissions in less than the allowed thirty day period.  He couldn't take the risk that medicare would refuse to pay him.  The new rules had burned him countless times already  She was too high risk.

The couple left the office dejected.  Faced with the fight of their lives, the abandonment of their long time physician was just another hurdle in a series of impossible challenges.

Dr. Sisk returned to his office and pulled up the schedule.   The next appointment was a new patient with congestive heart failure.  He grabbed the phone and dialed his secretary.

Marge, this new guy with CHF, did you do a hospital check before accepting him.

He typed furiously at the hospital EMR as he waited for an answer.  Just as he suspected!  Three admissions in the last two months.  Someone was trying to sneak this guy past him.  He spit into the receiver before his secretary could respond.

Marge!  You want us to go bankrupt? Get that guy off my schedule. 

Don't you dare check him in!


Lynda Halliger Otvos (Lynda M O) said...

Unbelievable, isn't it....

Mike Gamble said...

Thanks for the alert. I knew that the 30-day readmission rule applies to hospitals, but did not realize that it also applies to each and every provider involved in the process that lead to the readmission.