Doctor (Surgeon) Billing for Saying He Can't Treat You

Here’s the situation:

You have a doctor who says you need a certain surgical procedure done. He recommends you to a general surgeon and you schedule a consult to discuss having this procedure done. But when the guy takes a look at you he says you have a more complex case and he can’t deal with it (“I know my limitations”) - you need to see a specialist in this type of surgery.

Question is: should this surgeon be billing you for an office visit? He added nothing and only informed you that due to his own limitations he couldn’t help you. On the other hand you scheduled the consult and took his time.

I would think he should not bill, but my wife thinks I’m nuts and of course he should. (In the case which triggered this, the guy actually did :))

Office visit=money for him.

LOL. That’s amazing. Only in America!

Only in America would a professional not offer his advice and time for free?

Heck yeah he’s gotta bill. You being there was $X he could have made from someone else in that time slot.

Send the bill to the Dr who referred you. Bet he doesn’t ‘need’ to charge another doctor!

Okay. I guess the OP can take that into account.

Yep. I paid it one time. $60. It was even cash - the receptionist told me I couldn’t pay with a credit card, it was cash or check, and made me go outside in the hall where an ATM was located. Pretty annoying to have a surgeon refuse to do their job (and they could help me, they just weren’t willing to do it when I had to leave in a couple weeks and wouldn’t be able to make follow-ups)

Of course you are charged for his time. If, after the exam, he offered to do the surgery but you never followed up on it he’d charge, right? I’d be more unhappy with the referring doctor.

It makes sense. Think of it as a consultation fee. Now you know more about it.

No, the whole point is that I don’t know anything more about it. The only thing I learned is that this guy is not capable of doing the procedure, which is of no interest to me.

[If the guy was able to do it and I turned it down, it would be a different story.]

Why is it any different than a plumber or electrician charging a service call fee? Time ain’t free.

I do not know – please send me $250 for the consultation.

I was actually thinking the same thing. A plumber or an electrician would never charge you for a service call if they couldn’t fix the problem.

Unless it was something out of their field, like you called a plumber and it wasn’t a plumbing problem. But if they came down and it was a problem in their field but they weren’t skilled enough to fix it, you would not pay.

That first sentence is not true at all - there is often times a ‘trip charge’ - it usually gets rolled into the bill as the ‘first hours work’ IF they get /do the job - if they don’t, they want the trip charge.

They don’t want people towaste thier time.

Now - sometimes this might get waived for a variety of reasons - getting estimates being one of them - but its not at all uncommon to have an upfront fee for coming out (one idea being that kinda ensures they get to do the work - you’ve already paid them part of it) -

Well, in our area, you pay for the time the plumber spends on the road driving to your house.

In any case, of course the doctor gets paid. You are paying for his experience; if his experience says he can’t do the job, you’re getting what you paid for. Remember, took him years of getting a degree and performing operations for him to know what answer to give you. Or would you rather he perform the operation when he admittedly wasn’t capable of it?

The issue is with the referring doctor, who should have sent you to someone else.

That’s true if they diagnose that it needs such and such job and you elect not to have them do the work. If you already know what you need and they come out and say they can’t do it they would absolutely not charge you.

I wouldn’t use the word ‘absolutely’ there - trip charges are common - sometimes that means determining they can’t do it- and if they already know what you need, they already know if they can do it.

Your surgeon may have been perfectly capable of doing the surgery in ‘general’ - but after having time to review the files and you physically - determined they could not do that one specifically - they get paid for that time.

I work for a surgical practice that performs elective as well as medically necessary surgeries. Our procedure, and it’s pretty common in the U.S., is this:

If you’re coming in for a consultation for an elective surgery, the consultation is free. After all, we’re hoping you’ll decide to spend several thousand dollars of your discretionary income on (for example) LASIK, so we make it free for you to come in and find out if you’re a good candidate.

If you’re coming in for a consultation for a medically covered surgery - say, cataract surgery, or a cornea transplant - it’s a billable appointment. If you have medical insurance, they generally cover those preoperative and visits anyway, the same as they would cover the surgery itself. It’s still a billable appointment even if the surgeon decides surgery isn’t advisable in your case, or he decides you would be best served by a referral to a different specialist. After all, the patient has still made use of the surgeon’s time and training.

And there would really be no incentive for the surgeon to turn away a surgery; the $40 copay and $80 insurance billing for those consultation visits aren’t enough to keep the lights on at a surgical practice unless they lead to $10,000 surgeries on at least some kind of regular basis.

The OP should’ve insisted the general surgeon do the procedure despite his misgivings.

What’s America coming to when people concede their limitations?

Well, you paid for the “opportunity” to know more about it. It’s like how the laws purchase its authoritative power by offering rights in exchange for the power. The laws don’t enforce the laws just for the sake of enforcing though (& not just because of the rights).