By James Young, Attorney, Morgan & Morgan Complex Litigation Group
Almost everyone likes their doctor. Even when you end up waiting a long time in the exam or waiting room, or receive a diagnosis you don’t like, most still people report high levels of satisfaction with their physician.
However, very few patients take the time to properly research or investigate the people who make life and death decisions for them. How well should you know your doctor?
Trust, But Verify
President Ronald Reagan famously used the Russian proverb, “Доверяй, но проверяй” (Doveryai, no proveryai), translated as “trust, but verify.” This phrase suggests one should begin with a foundation of trust, followed by additional efforts to validate or certify such trust.
The phrase became an instant soundbite for President Reagan, who used it frequently when discussing U.S. relations with the Soviet Union. International diplomacy often requires such trust up front since the other side is not physically present within the country promising compliance.
Patients are similarly placed into positions where they have no choice but to trust their doctors. Many patients only see their doctors for a brief period of time and the information exchange with them is designed to be one sided, from patient to doctor, not vice-versa.
However, patients would be wise to heed President Reagan’s words and verify the trusting assumptions placed on these providers.
Is Your Doctor Who He Says He Is?
The initial bit of trust we place in healthcare providers is that they are who they say they are; physicians. All patients assume their physicians graduated from accredited medical schools, passed all required boards, completed their residencies, and currently maintain active licenses to practice. Some people are oblivious to the distinctions between MDs and Dos, or between ARNPs and Physician Assistants.
We also just assume regulators or law enforcement would shut down unlicensed doctors, but how often as a patient have you actually verified any of those assumptions?
The next layer of trust in this puzzle is assuming that your physician’s reputation, history and experience meet your expectations. How would you feel if the surgeon who is about to perform a serious procedure on you had been sued for medical malpractice while performing the same procedure last year.
What if they were sued multiple times? What if they failed to carry sufficient insurance to cover those losses and declared bankruptcy as a result? Do you care if they were arrested for a DUI, domestic battery, or drug crimes.
It is easy enough verify many of these assumptions, but very few patients actually do so. For example, Florida residents can visit Florida’s Practitioner Profile online to review their doctor’s credentials including: education, complaints, disciplinary actions, financial responsibility, emergency actions, privileges, certifications, etc.
Is Your Doctor in the Pocket of a Drug Company?
The final and more complex bit of trust we place in our healthcare providers is that the decisions they make are actually in our best interest. Most patients are unaware of the extent that their healthcare provider may be conflicted in their decision making.
A recent Drexel University study confirmed that a great majority of patients in the United States visited a doctor who received payments from drug companies, but most have no clue about it. Only 5 percent of those surveyed knew that their doctor had received such payments.
Does it matter if the drug company who makes the medication you are prescribed — over the nearly identical competitor or generic version — pays your doctor to be a speaker at continuing medical education seminars?
Fortunately, you can find out the amount or extent that your physician received money from drug or medical device companies by visiting the Centers for Medicare & Medicaid Service’s open payments physician website.
Moreover, most patients do not understand the extent to which physicians rely on doctor referrals. When a physician enters an order for your mother to go into assisted living, should it matter that they are a medical director for the facility they refer her to?
Breaking Down Your Medical Bill: It’s Complicated
We all trust that doctors will only bill for services actually provided. How many people actually read and understand their explanation of benefits or EOB? By using a complicated set of codes, acronyms, and abbreviations, health care providers essentially invented a separate language only they understand.
Would you care if your provider billed your insurance for a level 5 visit (requiring complex treatment decisions and 30 minutes of face to face time), when in reality they saw you for 5 minutes on a simple issue?
It is a tough pill to swallow, but healthcare consumers must face the reality that they simply do not know nearly enough about their doctors to substantiate the incredible degree of trust we place in them.
It is okay to place trust in physicians, but take a moment in advance of your next appointment to verify your trust.
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