[Doctors talk freely. Painted Benevolence]Medical Insurance Doubts: Case 3

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As a doctor, I will always try my best to help the patients who come to seek help wholeheartedly in my medical career. In theory, there should be no problem in practicing medicine according to this method, but as I grow older and become more With the accumulation of experience, I gradually discovered that in the process of practicing medicine, I will encounter some medical situations that are “thankless” or even “challenging the moral bottom line”. The following is a case encountered in clinical practice for readers Reference.

Insisted on physical examination and asked to write hospitalization form

Looking at the inpatient medical insurance claim form on the table, I couldn’t help but gasped and said:

“Miss Jiang, it’s not that I don’t want to help you, but that I can’t help you at all!”

“Doctor Huang, please don’t say that. In fact, this matter is not very complicated. You just need to write that I have been hospitalized in your hospital, and I have done some examinations, and then you will stamp your title of specialist doctor. , the follow-up will be handed over to my insurance company, Mr. X, and there will be no difficulties at all. Besides, the doctor XX I know has helped me in this way before. Why are you so stingy and can’t help me? once?”

Miss Jiang said to me one morning when I was about to see a doctor.

The whole thing happened like this.

This Ms. Jiang came to the clinic about a month ago. At that time, she said that she was uncomfortable all over, including loss of appetite, easy insomnia, easy abdominal distension after meals, occasional chest tightness and heavy head from time to time, rapid heartbeat, and easy nervousness. , so I want to ask for a full body check.

Seeing so many symptoms of her discomfort at that time, I suggested that she go to the health examination department for a full-body health check. At that time, not only can she choose the package she is satisfied with, but it should be better to find problems, and the cost will be relatively cheap.

Helplessly, she still insisted on asking me to do some examinations for her in the outpatient clinic. With the idea that patients have the right to ask for examinations, after discussing with her, I finally did some examinations, including blood draws, urine tests, and brain computerized tomography scans. Chest X-ray and electrocardiogram, no major problems were found after the examination.

After the patient knew the result, he took the report back and never came back for a follow-up visit. Unexpectedly, about a month later, she appeared in the outpatient clinic again and asked me to fill out the inpatient medical insurance claim form for her, which sounds really difficult.

“Frankly speaking, Miss Jiang, if you are not hospitalized here, you cannot apply for hospitalization medical insurance benefits. Besides, there are many items in this form that I can’t fill out at all, such as your admission time, discharge time, diagnosis when you were admitted, and what you did when you were hospitalized. Examinations, treatments given, vital signs, etc., all of which are not recorded in medical records, so if I can write something, it is completely made up.” I replied.

“Dr. Huang, I spend more than 6,000 ringgit a year to pay for this medical insurance, and I have paid for it for more than 5 years. I just want to use this medical card to do some health checks. The last time I came to you for a checkup It cost me 2,000 ringgits, and I want to apply for medical insurance benefits, is it wrong to do so?”

Adhere to professional ethics and moral bottom line

“Besides, when I bought insurance, the salesman once told me that this medical card is easy to use. The most important thing about medical insurance payment is to see how the doctor writes it. As long as the doctor is kind and writes the disease as ‘serious’, then There should be no problem with payment.” Miss Jiang said confidently.

“I said Miss Jiang! Don’t embarrass me. A medical report like this is obviously a fraudulent insurance company. It cannot be covered by paper and cannot be written. But if you can get the outpatient medical insurance payment form, Maybe I can still help.” I said firmly.

“Forget it, it’s fine if you don’t want to help me, I will go to another doctor.” Miss Jiang said displeased.

I believe that I will lose this patient because of this, but if I don’t put “medical professional ethics and moral bottom line” in the middle, it will definitely be difficult to go on the path of a doctor.

(Guangming Daily/Doctor Column‧Author: Huang Xueqian)

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