Imagine this scenario, the doctor tells you than you need a procedure, whether it be a colonoscopy or arthroscopic surgery. You’re scared, but the doctor assures you the procedure is routine-so routine, that the doctor will perform the same procedure/operation up to 12 times that same day. If you knew the doctor was performing the same procedure up to 12 times that same day, would you want a different doctor? Would you want to be the first patient when the doctor is rushed, or last when the doctor is tired? How long does the AMA(American Medical Association) say the procedure should take? How long does my doctor take to complete the same procedure?
An article published in The Washington Post illustrates how the AMA’s assumptions about procedure times are exaggerated in order to inflate the reimbursement rate for that procedure. As noted in the article, a single committee of the AMA, the chief lobbying group for physicians, meets confidentially every year to come up with values for most of the services a doctor performs. Those values are required under federal law to be based on the time and intensity of the procedures. The values, in turn, determine what Medicare and most private insurers pay doctors.
The article highlights Dr. Harinath Sheela, whose typical day was twelve colonoscopies and four other procedures. If the American Medical Association’s assumptions about procedure times are correct, that much work would take about 26 hours. Alternatively, Sheela’s typical day was nine or 10 hours.
In justifying the value it assigns to a colonoscopy, the AMA estimates that the basic procedure takes 75 minutes of a physician’s time, including work performed before, during and after the scoping.
But in reality, the total time the physician spends with each patient is about half the AMA’s estimate — roughly 30 minutes, according to medical journals, interviews and doctors’ records. Thus, appointments are slotted every 30 minutes. I don’t know about you, but I don’t want my doctor rushing thru 12 procedures every 30 minutes.
From a Medical Malpractice perspective,there are 2 obvious areas of inquiry. First and foremost, was the procedure medically necessary, or is the doctor performing unnecessary procedures for money.
Secondly, If the patient had a bad outcome or if the doctor missed something, was it because the doctor was rushed?
As a Medical Malpractice lawyer in Miami, I always request the doctors schedule for the day in question. Appointments are often scheduled every 15 minutes, and multiple procedures are scheduled for the same day. This makes it very difficult for a doctor to argue that his treatment was not below the standard of care, when the doctor is rushing from one patient to the next.