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Trisha Torrey

If I Don't Do My Job, I Don't Get Paid. But When Your Doctor Makes a Mistake....

By June 15, 2008

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... you are still expected to pay your bill. Right? At least that's how it usually shakes out.

In truth, most of us don't think too much about it. We visit the doctor, pay our co-pay, and if something doesn't work out right, we return to the doctor's office. The doctor tries again. We pay another co-pay, and so it goes.

It occurs to me.... what ever gives a doctor an incentive to find the right answers? Make the correct diagnosis, or prescribe the right treatment... If he or she is wrong.... then you just come back and pay them again. No incentive, or at least not much of an incentive to be accurate.

And if you have insurance, it's even worse. They simply bill the insurance company and don't need to deal with us at all. What's wrong with this picture?

The question was sparked by an email from Heather, asking about whether she could withhold payment to her doctor who just refused to treat her.

Heather visited her doctor on the East Coast complaining of shortness of breath and wheezing. She had been exposed to bronchitis. She had had bronchitis before and knew she felt very much the same way as when she had it previously.

But the doctor would not listen to her. He told her it was stress. Granted, Heather was getting ready to move to the West Coast, and of course, moving is highly stressful. However, two days later, Heather returned to that doctor because she was getting sicker. Again the doctor told her it was just stress and would not treat her except to tell her not to be so stressed! She was enormously frustrated.

After her move to the West Coast, she continued to get sicker and finally could not walk up a flight of stairs. She found a doctor in her new city, made an appointment, and was so sick when she got to the doctor's office that they put her on a nebulizer before the doctor even looked at her. Sure enough, she was diagnosed with bronchitis and sure enough, she was given the antibiotic she needed -- the one the first doctor refused to give her. Within a couple of weeks, the bronchitis had cleared from her system.

But here's the kicker. The East Coast doctor is now insisting she pay the bills from her visit to him. Doesn't it just make you mad? Heather wrote me to ask me whether she should pay him. After a few emails we agreed that she has some letters to write, an insurance company to contact and perhaps a guilt trip to try to lay.... but the bottom line is that he CAN insist she pay. And he CAN negatively impact her credit report if she doesn't.

When my misdiagnosis odyssey was over with, I sent a memo to all the doctors who had participated in the bad decision-making and told them I would not pay them, and insisted they send me copies of a final bill with the balance zero'd out. They all did it.

I would encourage you, too, to stick up for yourself. It's a question of respect and holding those professional medical toes to the fire. Don't push it so far as to let it impact your credit report. But do make it uncomfortable. And let your insurance company know, too. It's right and it's fair that you not pay for services not rendered.

And let us know in the Forum if you've done so -- please? We need some good examples to encourage other patients to do the same.
Photo rocketegg / istockphoto.com

May 17, 2009 at 4:40 pm
(1) Steven G says:

I work in the medical field and can tell you that there is such a thing as failure to diagnose. That is a sueable offense that can directly impact both the doctors medical license and malpractice (most groups pay for each individual physicians malpractice anyway). If that was me I would have consulted an attorney and see what my legal rights were since the doc (probably an IM or FP) put his/her personal feelings and thoughts infront of the qualitative evidence

June 28, 2009 at 7:58 am
(2) darlene bear says:

i went for a scope down my throat my doctor tore it over 3cm no lawyer will help because iam ok so far but what about my bill and why should my insurance pay and she gets off the hook

July 30, 2013 at 8:19 am
(3) sandyt says:

My husband caught his thumb in a tool and nearly amputated it one Friday morning. We went to the ER. I specifically asked if they had a hand surgeon and was told yes by the nurse. After the xrays where they determined he had a “broken” finger, they prepared to stitch him up. I left the room at that point. He said they poured two bottles of sterile solution over the thumb, gave him a shot and stitched it up. I was to change the dressing the next day. And they told us we might want to see a hand surgeon on Monday. I thought their doctor was a hand surgeon! At any rate, the thumb looked terrible. Since we don’t have insurance or worker’s comp, he didn’t want to go to another doctor, but by Monday it looked really bad and I convinced him to go. We went to an Ortho Clinic right next to the hospital. Long story short, they said everything the ER did had to be redone since the bone in his thumb was “crushed” and their was a blood clot under the nail. He had surgery the next day. The doctor told me he found about 40 pieces of paint and metal fragments in the wound. The ER had not cleaned it properly! Had he not gone to the Ortho, he would have lost the thumb or worse! Now I’m getting bills for thousands of dollars from the ER and their doctor! Do I have to pay? Do I have a case?

July 30, 2013 at 8:30 am
(4) Trisha Torrey says:

Sandy – It certainly sounds like you have a case, but my say-so won’t hold a drop of water.

You’ll either need to make the case yourself (be sure to keep ALL the paperwork and write down exactly the experience as you remember it, and ongoing do the same) – or – you’ll have to hire a medical billing advocate (a form of patient advocate) to help negotiate it.

Here’s how to find a choose a patient advocate who can help you with medical billing.

Best of luck.


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