"Sir, we're going to need to get your consent for a blood transfusion."
"No."
"Your blood count is really low. We need to do a transfusion-- it's important."
"No, this is the kind of thing I want a second opinion about."
"Sure. Would you like me to get the other doctor [my resident] in here to talk to you?"
"No, I mean, look: I know this isn't the only hospital in the world."
"This is a standard procedure, lots of patients get transfusions-- I know it sounds alarming, but it really does happen all the time, it's safe, and it's important to get you on the road to recovery."
"I know what you guys try to do. You try to get us to say we'll let you do all sorts of stuff we don't need. That's how you work. Well, I'm onto you."
"I promise you, we wouldn't want to do this transfusion unless we really needed to. I'm happy to get the other doctor to come in and explain it. I'm happy to get [the attending] to explain it next time he comes by."
"You just want to do it because you'll make more money."
"I earn a salary for working here-- I'm not paid based on how many things I do to the patients. I'm paid the same thing whether we let you lie here and don't do anything, or we do a million different things to you. It doesn't matter to me. I just want to do what's best to get you healthy enough to leave."
"Well, someone's making money off it."
"I assure you, this has nothing to do with anyone making any money off a blood transfusion. It's important that we do this. Do you want me to come back after lunch and we'll talk about it some more?"
"I'd rather talk to the lady doctor about it."
"Okay then."
Sunday, May 23, 2010
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While a sad commentary, it is a sad commentary on the results of procedure-based compensation. The public no longer trusts that the medical profession is looking out for its best interest. The AMA perpetuates the problem by constantly harping on $ issues. The public (erroneously) equates the AMA with "doctors." When it sees the AMA speak about nothing but money, it thinks that doctors are concerned with nothing but money.
ReplyDeleteHow much does the hospital charge for a blood transfusion? How much does it pay? (Is the blood donated? What's the processing fee?)
ReplyDeleteAs a former blood-banker, the cost we paid for a unit of RBCs from the red cross was somewhere around $300. Patients were charged somewhere in the neighborhood of $350, but as AnonDoc pointed out today, it really depends a lot on the deal that the insurance company and the hospital have worked out.
ReplyDeleteBlood must be donated, it cannot be paid for. The ~$300 cost is to cover the processing at the Red Cross, from the original collection to testing/processing, and delivery to the hospital. All things considered, it's relatively cheap as far as life-saving medications go.