Who Is Responsible?

But doctor, ultimately it is your responsibility. I can hear the case coordinator clicking her fingernails against the desk through the telephone line. I admit, I forgot to specify to the nurse, when she called me ten minutes before midnight, that this was a full admission and not an observation. In the absence of my order, a nurse manager reviewed the chart and decided that the ninety five year old woman with congestive heart failure and positive cardiac markers was appropriate for observation status. Of course the order can be changed, but one day will be lost. She will have to stay in the hospital an extra night in order to qualify for the nursing home. But doctor, ultimately it is your responsibility. The physician on the line doesn't actually practice medicine. He gets payed by the insurance company to sit behind a computer all day and talk to clinicians like me. I wonder if he knows what it feels like to push on a belly and suspect catastrophe. I do. And occasionally I order a stat cat scan on a patient who is writhing on my examining table to rule out such horrible things. Apparently I should have done a plain film first before moving to a cat scan. Maybe then the CT would be paid for? But doctor, ultimately it is your responsibility. The coding and compliance people are reviewing a dozen of my outpatient charts. Some are over coded, some under coded. Occasionally my ICD's are all wrong. It's funny how the quality of care means next to nothing. The dictates are qu...
Source: In My Humble Opinion - Category: Family Physicians Authors: Source Type: blogs