Doctor needs to perform surgery but with charity care, seemed unhappy

[onlyj]

My mom had to go to a specialist doctor (proctogloist- colon and rectum doctor) because every time she had a bowel movement, she felt part of her rectum come out. I found online that it was something called rectal prolapse. She doesn't have insurance and cannot afford healthcare, but I took her to see the doctor. The doctor asked her to push to see the rectum come out, but couldn't see it. She asked me to take a picture of it because she needs to be 100% sure. She saw that we didn't have insurance so she asked us how we would pay and said out of pocket. She asked if we were able to pay and there's something called charity care in which we apply through the hospital. She said we should apply since my mom might require surgery. She said it takes a few weeks for the papers to be processed, and then she made a statement. She said, unfortunately she wouldn't get paid since it's through charity care, and I felt bad and embarrassed. She said to come back in a few weeks when we get the charity care approved and with the picture. I feel horrible that the doctor wouldn't be paid at all when she had to perform surgery and a colonoscopy. Is there any other way I can do something?

[Spidey's mom, ADN, BSN, RN]

I don't understand what unprofessional thing the physician did? What am I missing?

I agree. I'm not seeing anything unprofessional.

Here in California, a social worker could help you see if your mom qualifies for Medi-Cal (Medicaid in other states) or Medi-Care. This may already have been done since the physician went straight to charity care but if not, then yes, apply for the charity care.

Kudos to the doc for suggesting it.

[chorkle]

Speaking only to this one issue, in this thread--"the doctor can write it off on her/his taxes", I wonder whether some of the posters here understand this issue (in the U.S., only).

Generally, in the U.S. tax law, and in IRS regulations, there is no "write-off"--i.e., no tax return deduction--for monies not expended. Iow--in this sort of situation--if you didn't actually spend your money for something, there is nothing to "write off." What you have is foregone income, or, nothing.

And if one does charity care, or pro bono work, or smth similar, there is no deduction available for the "value" of one's services, as there is no objective measure of it. And I believe it's true that no deduction is ever available for (monetary, or items of value) contributions to an individual; deductible contributions must be made solely to certain qualifying organizations.

Hope this helps.

[mike109810]

Exactly as PP it's a write off, they can use it as charitable contributions on their taxes. So boo hooo for the doc. It was UNPROFESSIONAL of her to say that. In addition, some docs who still have loans to pay for their education, they get a certain amount of loan forgiveness by doing charity care. So it's a win win, while the doc was not professional, it is doing a service and while the cash flow would not be recieved she will be compensated in some form.

Wow, I guess you are d*mned if you do, and you are d*mned if you don't. I don't see how ANYTHING that happened here was unprofessional at all. The doctor may have been less-than-tactful in her choice of words, but let's see the big picture:

-Physician suggested to the patient to participate in a program that could potentially save her thousands of dollars

-Physician is willing to do the surgery unpaid

-Physician seems to show concern for the patient's financial well-being.

This, my friends, seems like a good doctor to me. Also, I don't think you understand the concept of "writing off". It doesn't work like that. Say if I owned a company, and had to rent a car to shuttle around clients, I could "write off' the cost of the rental car from my income. This doesn't mean that the government will pay me back, it simply means that I am not responsible for paying income tax on that portion of my income.

Moreover, there is NO loan repayment program that gives money back for simply doing charitable care. I am a recent medical school graduate, and looked into COUNTLESS repayment programs, and never found anything like this. The best program for repayment is the National health scholarship program that pays you back for each year you work in a medically underserved area.

You, as a nurse, feel that you deserve to be paid for your work...right? Why shouldn't the physician feel the same way. If the physician truly was greedy, she would not have done the surgery. Medicolegal ethics and laws state a physician has no legal obligation in this type of scenario to perform the surgery.

I just fail to wrap my head around the (limited number of) NEGATIVE comments against the physician in this thread. Back when I was in undergrad and didn't have health insurance, I remember the physician in my college town waived my bill for a visit; I still remember what he did, and have sent him a Christmas card every year since this happened. The bill was for sixty dollars, and even though it was a small amount, it was truly a touching gesture. I currently have 10's of thousands of dollars in loan debt sitting on my head right now, so I just can't understand the posts that are blaming the doctor.

To the OP--try seeing if you qualify for state medicaid. This would be a great option, and you would be able to have the surgery performed at little or no cost to you.

[Spidey's mom, ADN, BSN, RN]

I work with a group of docs in a rural area who do over and above what they are supposed to do by making house calls, waiving fees for patient care, etc. Many also volunteer their time with Red Cross or other medical missions or local missions.

I have great respect for most physicians. As in any field, there are a few bad apples (nurses included).

Why are some insisting that physicians need to be "saintly". Remember the threads here that drive some of us crazy insisting that nurses = angels?

This doc did a good thing.

[gentlegiver, ASN, LPN, RN]

My daughter had to have an emergency hospital stay, the social worker went up to her room and helped her fill out the paperwork for Charity care. She was approved and they paid for her entire hospital stay. Thank God there are people out there that do this, daughter couldn't afford the stay, didn't have insurance, had no way to pay, and I could not help her at the time. Don't be embarassed, sometimes we all need help. Hope your Mom feels better soon.

[Rob72, ASN, RN]

My suspicion would be that the doc was simply stating a fact that was letting you know that whatever the hospital's charity panel had to say, she would not be part of the price you are finally given.

I've had people up in arms with docs because the patient qualified for charity- but it still wasn't the bargain that they hoped for. This is in no way a condemnation for you, OP, my family and I have applied for charity also, its just the HUGE sense of entitlement some folks have.

Whatever you receive (and I hope its adequate) accept with grace and without shame, and try to help someone else in whatever way you're able, at a later date.

[leslie :-D]

She said, unfortunately she wouldn't get paid since it's through charity care, and I felt bad and embarrassed. She said to come back in a few weeks when we get the charity care approved and with the picture. I feel horrible that the doctor wouldn't be paid at all when she had to perform surgery and a colonoscopy. Is there any other way I can do something?

i bolded what i found inappropriate.

why would any professional dr. add such a guilt-ridden statement to a pt?

i mean specifically, "unfortunately"???

i found it highly tactless and NON-therapeutic.

and her tactic worked, in that she made the pt feel horrible/guilty and likely, humiliated.

for those who support the dr, you find nothing wrong with what she said to a pt?

leslie

[leslie :-D]

Don't be embarassed, sometimes we all need help. Hope your Mom feels better soon.

you're right gentle, she shouldn't be embarassed.

it's unfortunate the pt's embarassment was the result of the dr's tactless statement.

leslie

[dudette10, MSN, RN]

for those who support the dr, you find nothing wrong with what she said to a pt?

leslie

In reading the entire OP, no, I didn't.

If the patient had brought up charity care as an option, and the only thing the doc said was, "Unfortunately, I won't get paid," I might have thought differently.

ETA: I'm not "supporting" the doctor; I'm just not getting offended by the doctor.

[CrunchRN, ADN, RN]

Nope. The fact that she was even willing to see the patient amazed me.

Most specialists would require a no insurance patient to pay a hefty cash down payment before they would even see them.

And the reality is she will probably be paid nothing or very little for doing the surgery. And yet, although she could easily opt out of the whole thing she is trying to hook them up with a plan to cover the hospital bill and do the surgery.

I see nothing wrong with being up front about the situation. It is not meant to demean anybody. It is just the situation. The reality.

Wouldn't you be a little bummed if you learned you were not going to get paid for your work. Again..........