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Tue Jan 13 18:46:58 GMT 2009

From: William Bromberg (brombwi1 at memorialhealth.com)  > We routinely rescan patients for these reasons...

--> I think there would be little debate on whether one should re-scan patients if images are sub-par, unreadable, wrong format, no contrast or other ommissions, etc...
My comments were in reference to the original thread, on re-scanning patients for "cannot double dip, hence no pay, hence no read" [Joe Nemeth, Mr (joe.nemeth at mcgill.ca)]

> 4. The referring facility reports never come with the patient (like all rads reports the formal report doesn't happen for 24hrs

--> In which case I don't see a benefit for re-imaging, as you'll not get YOUR radiologists to report them within 24hrs if they "all" don't

> don't get me started on the fact that the radiologist can bill for picking up a pneumothorax 24hrs after I've already treated it

--> I promise not to get you started on this!I have never been able to comprehend what makes anyone do radiology in the first place...But in your context, I guess you could look at their "delayed reading" as you do upon a historian documenting the past ;-)

> I don't know what the malpractice situation is like in Oz...

--> Me neither!Methinks you confuse my "accent" as Oz, but I'm in the UK... Have been in South Africa and elsewhere. But not Oz...
Still I'd bet big money that their "malpractice situation" is better than in the USA by a very very long way (from a doctor/patient point of view, not a lawyer's).

> but expecting physicians to accept the liability without any reimbursement is not only fundamentally unfair IMO but in fact will just not happen in most facilities

--> I do not look at the stupidity of involving litigation in medicine any differently than involving profit in it. I see legal & financial as equipotent & equivalent sides of the same coin. I.e., in your context, I think that the ONLY fear here is financial - the liability worries people in terms of what it would cost to lose a case financially.

> Performing a "dummy scan" and billing for it would be considered knowingly fraudulent behavior in the US and would result in fines and prison terms

--> I was not being serious, y'know...Us ozzies have a funny sense of... Wait - I forgot I am not Ozzie...

Still is this not funny?Say you receive PERFECTLY ADEQUATE AND READABLE images...But your local dark-man refuses to read them for lack of profit for himself...How so quickly we expect one go to court for my "fraud", but all is instantly "legal" if one adds some unnecessary irradiation, generating identical images and harming the patient... That's Kosher!

From: Gross, Ronald (Ronald.Gross at bhs.org)  > This is the way our guys handle these things as well. We need only give them the disc so that they can (1) load the images onto the PACS and (2) put in an "official" order for radiology re-read of outside images. When necessary, they will let us know when we need to re-scan or image the patient.

--> Thanks for this!I'll save myself the effort of trying to further explain the point, 'cause here are least two places which work "sensibly" (at least by my logic)!The question to all those who explain why this SHOULD NOT happen is "why not, if it does happen at least in these two places"?
Do their radiologists know something yours don't?Are there no lawyers where they are?Do their local insurers pay for stuff others don't?Do their outlying hospital radiology departments meet a higher standard?
Or are they simply doing what's RIGHT rather than what's PROFITABLE, without making excuses...

From: Fiona Wallace (tielserrath at yahoo.co.uk)  > perhaps the US system is different

--> ...and the Pope catholic...

> ... when you have a 3hour wait for a retrieval team to arrive, would it not be sensible to use that time to complete any necessary radiology, as long as it can be done safely?

--> "sensible"?Of course!PROFITABLE for the radiologist?
Not so much... I believe that was the original reason for the thread. Could it be that the originator of this thread was looking for a way/rule/system by which to CONVINCE or force his local radiologists to be "sensible", rather than profitable?

So... The 2-3 of you who have so far indicated that their radiologists are "sensible2 in this regard - could you provide any clues as to how to make other radiologists follow suit?
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