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Ask Dr. Gott 12/13

Padding bill an Rx for fraud

    DEAR DR. GOTT: Because of gastrointestinal symptoms and lower-left chest pain, I visited a gastroenterologist for the first time. While describing my symptoms and giving a history, the doctor was at his computer taking notes. He also accessed my records at the hospital where he is on staff and where I have had many tests and procedures.
    The specialist prepared a report for my family doctor, and I obtained a copy of the report for my files. When I read it, I was surprised with the entries under "Physical Exam." While he scheduled an upper GI endoscopy, he really did not perform most of the items he stated he did.     The only clinical exam was palpating my abdomen. I presumed that the entries resulted from his review of my hospital records. Is this proper?
    DEAR READER: No, it is not. This doctor is dealing in fraud. In order to receive higher reimbursement, the physician padded his bill to reflect an exam that was far from being as complete as indicated. Unfortunately, this practice is common and is one reason that health costs are escalating rapidly.
    I do not know how to avoid the padded bill except to discourage doctors from using it. If you are dissatisfied with this common practice, discuss the situation with him and request an explanation. If you don't get an acceptable answer, report him to your state medical society. The advantage is that he will — or should — discontinue the practice. The disadvantage is that you might have to find another gastroenterologist.
    To give you related information, I am sending you a copy of my Health Report "Choosing a Physician." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: I read with interest about the lady with persistent undiagnosed itching of her upper extremities. I would like to tell you about my son. About 10 years ago, he had general severe itching treated with creams, allergy products and more. At the same time, he had neck pain diagnosed as muscle strain that was treated as such. After months of unsuccessful treatment, he went to another doctor, where he had a biopsy of the lymph node in his neck. He was diagnosed with Hodgkin's lymphoma that had progressed to a Grade 3. He was 22. Once treatments were started, the itching disappeared. I am a registered nurse and should have recognized the symptoms, but I didn't. He has been dealing with the Hodgkin's for 10 years. He has had intense chemo and radiation and a stem-cell transplant that helped for about a year. Now he's undergoing spot radiation, his third session this year. If they radiate one area successfully, it pops up elsewhere.
    I realize that not all Hodgkin's patients present with itching, but it is an avenue that may have to be looked at. If this alerts just one person, it will be worthwhile.
    DEAR READER: Hidden cancers may cause intense itching. This is the reason I advise itchy readers to seek medical attention if the symptom is persistent and has no obvious causes, such as allergies. I am sorry to learn about your son, and I wish him well.

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