OK, let's call a spade a spade. The third party payers are getting stingier, there are more & more uninsured patients and more pressure to meet quotas on everything from length of stay to "uncompensated care". For example...
- "This guy is bleeding really badly and all but one of the gastroenterologists here is out sick or having a family emergency." Patient transferred to another hospital stable as a rock with Hgb 13 and is discharged the next day. Problem was, the hospital admin was on the doctor's case about "freeloaders" and the GI guys there were stalling so they wouldn't have to scope an alcoholic and then provide followup care.
- I'm leaving town tomorrow and my partner isn't comfortable managing his problems--can the hospitalists take over his care?" Translation: he's been here for two weeks and my length of stay numbers are already in the toilet, so how about you getting credit for the long stay?
- "It would help so much if you could round on my thoracic surgery patients--my PA can manage the chest tubes." Bets on whether the doctor will answer his cell phone from Aruba?
Anyone have some other examples of Crappy Doctor Tricks?
Editor's Note: No real names of hospitals or doctors please!