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Ethical Problem With My Heart Doctor - Please Reply

By August 7, 2008 - 10:01pm
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Tomorrow I'm going to meet a new doctor to look at my heart.

I've got an arrhythmia problem, it feels like it's getting worst, I've got a procedure coming and I scheduled an appointment with a doctor that came highly recommended.

My appointment to meet this doctor was really scheduled for last month. After sitting in a private patient room for 30 minutes waiting, the nurse came in and said the doctor is running behind and should be here shortly. So I laid down on the thin white paper and closed my eyes.

15 minutes later the nurse returned and said the doctor is in surgery, won't be able to make the appointment and another doctor was going to sit and review my tests.

As I was leaving I took the office manager's card and introduced myself. Later in the day I called the office manager and asked to reschedule so I could finally get to meet the doctor that came recommended. I also asked her to waive the cost of my doctor visit because I didn't get to meet with the doctor I was scheduled to meet.

LONG STORY SHORT: Tonight, just 20 hours before my appointment the nurse left me a voice mail saying the doctor is looking forward to meeting me tomorrow and has agreed to only waive my co-pay, which is like $10.

PROBLEM: Is it bad for me to allow them to bill my insurance company for a doctor visit that never happened? Should I be concerned or should I just allow them to do business as usual?

Thank you!


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HERWriter Guide

My daughter had an appointment to get fitted for an instep to help her little feet straighten out. We ended up not going through with it but the doctor billed anyway - and charged the insurance company $400! Had I not checked the letter from the insurance company in detail, I would not have seen it. $400 for insteps I could get for $75 if I did it myself!

I called the doctor's office and left a detailed message and they never called me back. Pretty 'shady' if you ask me but I couldn't get through the doctor's web of departments to pursue it further.

August 8, 2008 - 1:36pm

Wow Michelle, you are right on the money.

I'm excited to see if I have chemistry with the doctor today.

It's like dating, but I'm trying to set my heart up with a friend...that I trust. I mean, really, really trust.



August 8, 2008 - 10:30am
EmpowHER Guest

Hi Todd,

Here's my take on all of this. You, as a patient, always have options. The option here was for you to simply say, I came to see Dr. Smith and not Dr. Jones. So, I'd like to reschedule my appointment and I know you won't be charging me for today's appointment, right? That is always the best approach. Be direct and handle it right away.

The problem is you let the other doctor come in and talk to you. Their time has a price tag on it as well. That was a choice you made. Taking into consideration though, I'm sure you were caught off guard by all of this.

This goes back to being able to advocate for yourself and speak your mind. Don't wait. You must strike while the iron is hot. Never assume someones going to do what you consider to be the right thing. You know what they say about ass..uming, don't you???

Now, the core issue is, do you want to have a relationship with a doctor who's office didn't know if she was in surgery or having a latte?? Although, clearly, he or she may have encountered complications while operating. I would error on the side of the doctor and give he or she the benefit of the doubt... that something didn't go quite the way she thought.

Also, remember, everyone's time is so valuable. Your time is just as valuable as theirs. Could they have called you to tell you this ahead of time??? Maybe, or maybe not. That's a question I'd ask them. Is this typical of what happens? Do you ever try to reach a patient to reschedule if the doctor is running late or is stuck in surgery?

Now, you have to go back and talk to this doctor with all of these concerns and figure out whether he or she isthe best doctor for you. You know I talk about that "chemistry" thing with your doctor... a lot.

If this doctor is as good as you've heard.... And the chemistry is there. Then, I say, go for it. If not, go find yourself another doctor. The choice is always yours as the patient. You get to hire and you get to fire!!

As for the bill. You spent time with the other doctor and that doctor should be compensated for her time. Nothing unethical about what they did.

Best in health,


August 8, 2008 - 10:01am

Thank you both for giving me another way of looking at this.

I feel much better now after reading your thoughts and suggestions.


August 8, 2008 - 9:38am

There are so many ways to define "unethical", and also a continuum of unethical practices.

I guess I don't see this as unethical...or very low on the "unethical business practice" continuum.

To me, unethical practices are defined by dishonesty, immoral conduct, etc. They were at least honest with you, and told you what fees they would waive or not. It is not an immoral act that they committed. Is it a ridiculous business practice? Well, yeah!

I would separate the doctor's business practice from the doctor's practice of medicine.

August 8, 2008 - 6:59am

Hi Todd,

That is so frustrating! I would love to hear from someone who knows more about the "behind the scenes" paperwork/billing side of this story!

A slightly similar thing happened when we went to meet and interview pediatricians for 10 minute appointments (no exam), and one doctor charged us while the others counted it as a free consultation. I called the "charging" doctor's office, and they said once an appointment is "in the system", that it is automatically billed to insurance. I find that hard to believe that they let a system dictate their billing and practice...is there really not a great big "undo" button?

Perhaps this is your doctor's office system as well?

Either way, I say "let it go". As Carolyn Hax says: (sorry---an advice columnist): "follow your bliss". Don't worry about the smaller things in life that are unfair at this moment...there is plenty of time to "fight the fight" and help save the world from injustice and unethical practices.

Another way to reframe this: What are your options?
You can let your doctor and the office manager know in person that you disagree with their policy, and ask for clarification of the policy in person. That will make you feel better that you stood up for yourself, let them know that you disagree, and maybe learn that there is a good reason (ha!) for this policy. And, is it a "policy" or one lazy person who didn't want to do extra paperwork?

Afterwards, what are your options? Change doctors?

Right now, in my humble opinion, it may be a great time for you to take your positive energy and focus on getting better, and prioritizing what is most important in this situation:
1. doctor who is competent, credible, licensed, experienced & expert with my particular condition
2. doctor who I connect with in a patient-doctor relationship, who treats me with respect, explains procedures
3. doctor is highly recommended by people/sources I trust
4. doctor who is ethical in practice
5. location and convenience, as well as affordable

What are your thoughts? Is this a good way to feel empowered to find more information from the doctor/office, let them know you disagree , and then YOU have the power to choose to continue with their service or take your business elsewhere. If you choose to stay with this doctor who is highly recommended, reframe your thoughts about the doctor from being "unethical" (unless you have other information) and frame it as an "unfortunate office policy".

August 8, 2008 - 6:47am
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