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Another ethical question

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Maeve:
I have been going to a neurosurgeon who does not take insurance but was told he worked with patients with payments. According to the office the patient tells him when they want surgery so he sets that day aside to operate, but the patient is to check into the hospital emergency room as an emergency patient stating they have an emergency. Since he is the on call doctor he is the one the hospital will call. Since the patient is admitted into the ER as an ER patient the insurance will pay. I have a problem with going to an emergency room with an emergency that is not an emergency. Like it is pre planned. Not only does it feel wrong but the hospital that he prefers to operate from is 25 miles from my home and I bypass the two closest hospitals to my home and 4 more on the way.

Mary

nancyann:
Hi Mary:  if it feels wrong it is, go with your gut.   I don't like the sound of it at all.  Pretty sneaky if you ask me.
             Any other surgeons in the area you could go with ??

tony:
Perhaps we should ask a different question
I am sure, most, if not all this group
support the notion that the best AN surgery results
usually come from the most experianced AN surgery teams
Given that you may have to live with the surgical outcomes
for 20 or more years - it may be proudent to check
out options that maybe are further away from home
- but have done 100 or more such surgeries ?
Just a suggestion - its your call
Best regards
Tony

Evan:
Not only is it unethical, but it is potentially "insurance fraud", not necessarily on your part, but on the part of the physician.   The real question is whether he is doing this to "help the patient" or merely doing this to get paid for surgery that he would not otherwise get paid for.  Also, since there are so few neurosurgeons in each state (I believe New Jersey has less than 50 board certifed neurosurgeons), the fact that he has to resort to this does not sit well.  As one of the others has asked, the most important question for you is whether he is the best qualified doc for the procedure.  Many doctors, especially with uncommon conditions such as AN's will work with patients without insurance.  I suggest that you look around and explore all of your options.

Evan

Shrnwldr:
I agree with everyone on this.  Has the doctor performed this type of procedure before? And if so how many? If he has performed these surgeries then why isn't he signed up on your insurance whatever it is called...approval list?  Then there is the whole question of what happens if you need to see him for complications?  What about followup visits?  hmmmmm  Is there any other surgeon in the area that you would feel as comfortable with?  Arent' these slow growing so there would be enough time to alteast find a doctor in your network that would work? 

This just doesn't feel right.

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