There’s a big Internet dustup about a California plastic
surgeon who is being sued by the state to stop her aggressive billing
practices. The state medical board is investigating her for possible illegal
balance billing and may remove her medical license.
The LA Times ran a story
documenting the plight of a patient who cut off the tip of a finger. In the
emergency department, he requested the services of a plastic surgeon. The
doctor saw the patient and had him sign an agreement to pay for what she was
about to do.
It is not clear exactly what was done in this case, but
apparently, all the work took place in the ED. The surgeon billed the patient
$12,630.00 and received $3500.00 from the patient’s insurance carrier, which
she refused to accept. She billed the patient for the entire amount and sued
him when he didn’t pay. She also started a process to force the patient to sell
his house in order to pay her.
Some doctors are defending the surgeon. For example, the
blog White Coat Call Room said, “Suing a doctor and trying to revoke her
license because she wants to get paid the asking price for her services? If
people don’t want to pay her price, then don’t use her. Go see another ‘professional.’”
The LA Times article was posted on Sermo [free registration required
& restricted to licensed MDs] and has yielded over 280 comments, a large
majority of which are sympathetic to the surgeon.
There’s a lot more to this than you think.
Some have pointed out that patients often request a plastic
surgeon unnecessarily. I agree with that. But such consults are often
instigated by the ED staff and no discussion of costs or fees ever takes place.
I spent 24 years as a surgical department chairman fielding complaints about
this sort of case from both patients and surgeons.
Although the patient may have agreed to pay the surgeon, it
is not clear from the LA Times account that he was made aware of what the fee
would be before signing.
Some have suggested that because the surgeon was “out of
network,” she could bill whatever she wanted to. Nonsense. She was covering the
ED. She had an obligation to treat emergencies. Fees must be reasonable.
The fee of over $12,000.00 is outrageous for any procedure
done in an ED and particularly for what seems to have been a simple fingertip
repair. The $3500.00 payment from the patient’s insurance company seems quite
generous to me.
The surgeon has a pattern of this behavior having filed more
than 50 breach of contract lawsuits since 2010.
Most damning of all, the LA Times notes, “She attended law
school at UC Berkeley, though she is not licensed to practice law in
California.” Too bad. She would be a great lawyer.
To me, the plastic surgeon is simply greedy.
These are the kinds of stories that make all doctors look
bad. Is it any wonder that people resent us and don’t respect us as much as
they once did?
