Most of us go to physicians’ offices either for regular check-ups or when we need an evaluation or to have something about which we’re concerned checked out. Of course, there may be other times, but I don’t think anyone wants to sit around in a physician’s waiting room for fun, so I’ll say that just about takes care of it all.
Have you been to a new physician’s office recently? Allow me to be a bit bolder and ask one more question. Are you on Medicare? Ok, when you’ve gone to that new office, have you been handed a clipboard and asked to fill out a lot of forms? Have there been any forms that seemed new to you and which were listed as “health questionnaires?”
I recently had to accompany someone to a physician’s office and, yes, they had to fill out new forms. But while doing so, this new patient was pulled up short by the last two pages which seemed a bit out of place.
The question were phrased to delve into the patient’s current state of mind. “Have you ever felt like nothing mattered, you might as well give up, there’s no reason to go on” and on and on they went. Are you getting a bit of a hint here as to where this “health” questionnaire was going? Yes, you surely are and you’d be right if you said it was looking for signs of depression.
Depression is a very serious problem and more people suffer from it than we’d like to know. Certainly, it’s not something that comes up at dinner parties, “Oh, by the way did you know I feel like there’s no sense going on?” That would be a sure killer of the conversation. Lots of mild coughing at that point and quick shifts to other things much lighter, I’ll bet.
I, of course, am making light where you probably believe I am being much, much too cheery on a topic that is anything but cheery, but I have a point and it’s not about depression, either.
While you were completing that health questionnaire, did it ever cross your mind that you were completing a psychological evaluation? Did they ask your permission or ever ask if you’d consent to that type of evaluation? I will bet they didn’t because you, just like most other patients-to-be, just do what you’re told and figure it’s just part of the game.
Game it may well be, indeed. Do you know that, if you are on Medicare, they will pay for one depression evaluation a year? Yes, if you complete it, that office will submit that “health” questionnaire, aka depression screen, to Medicare and request payment for which they will, indeed, receive a check. Boom, done and with not a peep out of you.
Is that a little sneaky? I think it is. What they’re doing is charging for a service that they know Medicare will pay for but for which you never gave your consent. Isn’t informed consent what medicine is all about? Don’t you have a right to agree to a psychological evaluation or not?
The patient I accompanied told the office manager that there would be no completed “health” questionnaire and that it is unethical to stuff this into a medical record and not tell the patient about it or ask for consent. So, no Medicare payment for you guys this trip from this person.
Then, today I read about a 78-year-old physician who has been charged with the largest Medicare fraud ever — $200M. He funneled patients to one specific blood lab and received not only kickbacks from the lab, but a no-show job for his mistress. Now, he may be headed for jail and, poor thing, what will happen to his mistress while he’s away? Probably find another guy who has a stash of Viagra handy for just such occasions.