Something To Do With Money
We used to have an old Doc in town who had the same answer for every problem. Regardless of the issue at hand, when something was wrong he’d say, “I don’t know what the problem is here, but it has something to do with money.”
Most people in health care want to do right by people, and they are easy to work with. But, whenever I run into folks who will not act in the patient’s best interest old Doc’s adage can be used as a powerful motivational tool.
Take a case last month. I had a patient with a couple risk factors and a good story for a pulmonary embolus. (Blood clot). I wanted a CT chest to rule out a clot. The little chart review person at the insurance company told my people we would have to do a plain chest x-ray instead. With the diagnosis in question, that is a little better than a coin flip, but not much. They would not budge.
Often I have to call, but this time our referral tech was able to make them understand.
“What should I tell them Dr. B?”
“Hmn. Why don’t you go with the BBQ speech?”
In a minute she was back with an accession number. The CT was approved.
The BBQ speech goes like this:
“Y’all like BBQ?”
They usually say yes.
“Well, I’m glad, ’cause Dr. B says you might need to visit us for an extended stay.”
“Why is that?”
“He wants you to know if anything happens to his patient while you obstruct their care he keeps a lawyer on retainer. And boy does this lawyer love BBQ. We have the best down here. He thinks it won’t take more than two or three years to sort out. With her being a mother of three, he believes a jury would have enormous sympathy in the event of death from a delayed diagnosis of pulmonary embolism.”
“Yeah. He said not to worry too much. This is a rural area, he doubts it would go for more than three mill or so. Old Dr. B is a very patient man. Why he’s like a little terrorist; he ain’t going away. You’ll love it here. Like I said, the barbeque is great.
There are all sorts of variations on the theme, but the fundamental principle is always the same. You have to speak to what motivates them. I gave a up a long time ago trying to make them understand I hoped to help a human being; that matters to them not in the least. But when you start to talk money they will often listen. Like the Old Doc said, there’s something wrong here and it’s got something to do with money.
By the way, my patient’s blood clot treatment went well, and she should do fine.