Recently when I registered at a hospital for an outpatient study, the clerk pushed a single page through her window saying “sign this.” Her counter was at chair level, but I had no chair. I read the page, scratched out the assignment of benefits and permission to file insurance, and gave her the signed document. When I returned after the study to write that benefits could be assigned, a different receptionist handed to me not a one, but a two-page document.
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At an outpatient surgery center, I was handed two forms “to sign in the waiting room and give to the nurse.” On one of the two there was a line that said “the risks and benefits of anesthesia have been discussed and I wish to proceed.” I had not even met or laid eyes on an anesthesiologist. I scratched out that line and did not sign the form. Even at an outpatient surgery center, these words matter. Remember Joan Rivers.
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I stepped back from a new patient and instructed him to “dress and the two of us will make a plan.”
“No one has ever checked me as carefully as you have today,” he remarked. When I replied that Dr. So-And-So “had looked at him pretty carefully, right?” the patient replied “He did not.” I was holding a complete medical student history and physical.
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Reading other providers’ notes, I find way too many that are “cloned,” meaning only the date of service, not the blue book text changes. The blue book note is “copy, change the date and sign.”
What did you and Dr. Noname say about this? “I was not touched,” is the response. Yet I am looking at paper detailing an extended history and physical examination.
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A patient in northwest Georgia delivered a baby at a hospital under the care of a obstetrician who was an “in-network provider.” Her baby needed neonatal intensive care. That service was not “in network”. She should not have had to check out this detail while wearing a hospital bracelet. The story was printed in Time magazine within the past 12 months.
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Surgical sub-specialists rarely perform a multi-system physical. A urologist rarely if ever examines skin. Be suspect if the written record says otherwise.
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Each of these medical documents has the signer’s legal or the financial back.