The hand was examined and no nerve of joint injury was appreciated.
The laceration was cleaned and closed under local anesthesia. The surgeon's
time in the emergency room for this patient was 1 hour. Medicare and the
secondary reimbursed a total of: $21.39
three months after the case was billed (an average time). At this rate,
the case is not worth keeping the other patients waiting in the office.
I was late to see patients in the office as a result of taking care of
This nice 77 year old gentleman had injured his forehead
and eyelid in a fall earlier the same day. Hopefully, few emergency department
physicians would undertake such an injury without assistance. No argument.
This patient was better served by having a plastic surgeon address these
This patient's injuries were cleaned and closed under local anesthesia in the emergency department. The surgeon's time in the emergency room for this patient was 3 hours. Medicare and the secondary reimbursed a total of: $283.14 two months after the case was billed.
I don't really have an issue with managing emergency patients, but if only half of them have any coverage and those that do pay fairly poorly, it is not worth getting up from bed to go see them. This is nothing personal against people needing emergency care, but with this renumeration my coverage of emergency departments decreased to nearly none a few years ago.
Hopefully, this will be seen as it has been designed; namely as an explanation of the status of emergency plastic surgery in Southern California. Once upon a time someone would be able to respond:
"But those were Medicare patients! My insurance pays better! I have good insurance."
Seeing as most insurance companies in Southern California pay based upon Medicare rates (often less than Medicare rates), your statement would no longer be correct.
EDITORIALS | MAIN