DEAR DR. GOTT:
I am 83 years old. Recently I thought I was having a stroke so I called my doctor. He told me to go to the ER, which I did. After examination and a CT scan I was told I did not have a stroke but that I would have to stay overnight for observation.
When my physician finally came in the next day, I told him I wanted to go home. He said that I couldn’t because he wanted me to stay another night. I then informed him that I would go without his permission to which he said if I went without permission my insurance would not cover the stay or treatment. As he was leaving I told him he was only covering himself. He turned around, pointed his finger in my face and said “ABSOLUTELY”!
Later that day a social worker came to see me which is routine in my hospital. I mentioned the doctor’s behavior and what he said me and she responded “He knows better than that”.
When I was finally allowed to leave, I went home and called Medicare and my co-insurance. Both told me that what I had been told was not true; they would have covered the care up to the point I left, even if I left without physician approval.
When I went for a follow-up in his office, he opened the exam room door and immediately said “You are the hard headest patient I have ever had”.
I don’t see how I can continue seeing this doctor. I thought his pointing his finger in my face was not only impolite but also unethical.
DEAR READER:
The social worker who saw you in hospital was absolutely correct. The doctor does know better than to behave that way. He should also know that Medicare and other insurance will cover hospital care even if the patient leaves “against medical advice” (AMA).
Patients are free to leave hospital whenever they choose, but if they leave AMA they are required to sign a form telling them of the potential risks they are taking and that should any adverse events occur because of their premature leaving, all hospital personnel involved in the care and the hospital as a whole are not responsible.
Your physician was out of line for his behavior. It is common practice for physicians to cover themselves, especially in cases of suspected strokes and heart attacks; however, your physician went about the entire situation incorrectly. He should have expressed his concerns and given reasons why he thought you needed one more night of observation.
I have said it before, physicians are not gods, and their word is not infallible. Patients must take responsibility for their own health. Doctors should give options, explain the benefits and consequences of those options and then allow patients to make up their own minds.
If you feel you are not receiving proper care from your physician, by all means switch. There is no law stating you have to stay with one primary care physician for the rest of your life. Ask around, talk to your friends, family, even the hospital or local nursing services for their opinions of physicians in the area. Make get acquainted appointments with a few to see if you can find one with whom you feel comfortable. When you have found one, tell your physician to transfer your medical records to the new doctor.
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