Taking a Hard Look at After Hours Care
After hours care by doctors for patients who are ill or who have an emergency has been a fact of life as long as there have been doctors and patients. After all, as any mother of a sick child knows or any child of a sick or elderly parent knows, the phone call usually comes in the middle of the night, and your child’s fever seems to go up after midnight. We have all spent too much time too late at night trying to get someone to feel better.
These days, most of us end up trying to tough it out all night or, in a more acute situation we end up at the emergency room. Sometimes, a friend or loved one is admitted to the hospital and has to stay. Usually, their doctors come to see them during regular hours, but there are provisions within Medicare that pay doctors extra if they need to see their patients after hours.
Most doctors use these provisions responsibly. It makes sense that once they go home from a day’s work, they really don’t want to return to the office or hospital to see a patient unless it’s a true emergency. There are legitimate times for doctors to make that trek. For instance, my daughter broke her leg and needed surgery which lasted for hours. She was doing well, asleep late at night when she woke up screaming in pain with a high fever. The doctor was called; he came in and found a problem. He corrected the problem that night. Had he not come in at that time, she could have ended up not being able to walk again. That was a legitimate after hours visit.
The problem that Medicare is looking at is the fact that there are some doctors that are billing for after hours visits that are not necessary – or are not actually taking place after hours. As a result, Medicare is considering changing the rules and making it harder for doctors to get paid for this often essential service.
If your doctor tells you in the future that he or she cannot see you after hours don’t be upset with them. You can thank the doctors who abused the system for jeopardizing or eliminating a service that doctors have provided for many years because they care about their patients and their profession.
