DISQUS

CAN i get a HALLELUJAH!! YEA-AS INDEED.

I'm with you. I know docs that write "Go To Jail" and that is actually what our local authorities request. However, I write, "Medical screen complete, no indication for continued acute medical care."

I don't even measure initial alcohol if I can help it. I prefer, as you do, to evaluate the patient clinically. If they seem OK, I will discharge them. if not, I may have to check the BAL to get an estimate of when they may be able to go.

The problem is that there are people out there who would seem normal with a BAL that I couldn't stay awake long enough to achieve.

You're right again!

My comment was meant to describe the pay $40 and bill/get $80 scenario. Most of the offices with which I am familiar make a profit, in addition to the fee for the visit, when they draw the blood and send it to a lab. That's why they do it. Otherwise, they would just give the patient a slip and send him to a lab.

I acknowledge that medicine is different, but your mechanic does the same thing. If he doesn't have a machine to turn your rotor, he send them down the road, pays that guy, marks up the charge and get his money from you. Building contractors do the same thing. Your contractor charges you more for the roofer than he pays the roofer, even though you are paying him a contractor fee.

Other than the amount of money involved, how is this different from a practice contracting with a lab service for routine labs, like CBC's and metabolic panels? Most office practices bill for the lab test at a higher rate than they are charged by the lab itself.

A CBC might cost the practice $40 but they will bill $80.

I am not one who trivializes the specialty of EM. Obviously, one does dot need to be EM board certified to be an effective physician in the ED.

However, you seem to have lack of perspective regarding other specialties, especially FP, with you statement, "no other specialty is trivialized in such a manner" ignores one of my points, that there are very many not board certified FP/IM docs out there practicing general medicine. What do you think about a cardiothoracic surgeon opening a general medicine clinic? I just don't see other specialties being as sensitive about it as some EP's are.

Wow! is right. I must say, I feel attacked/defensive. I'm sorry I touched such a sensitive nerve. I think you may have missed my point entirely, which was pretty much the same as your point. Please see what I wrote about your post, which, with the exception of the straw man arguments you attributed to me, is well written. Actually, better than mine. I suppose if I had written mine better, you may not have felt it necessary to write yours :-)

Keep writing, keep posting, I enjoy your blog.