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Can a first year med student legally treat patients without direct Dr. oversight?


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63 replies to this topic

#1 DwayneEMTP

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Posted 03 December 2012 - 04:47 PM

During my recent tachycardia issues I went to an Urgent Care to get an ECG. I'd asked specifically if I'd be seeing a physician, as I wanted a physician level assessment, as was told that I would.

While waiting a young man came in an introduced himself as a medical student and asked if it was ok if he interviewed me while I waited for the doc. I said 'sure.' It was obvious that he had no real idea how to do such an interview, he kept checking a sheet of paper for further questions, but ended up asking only a half dozen or so. No touching of any kind was done. They did an ECG, and he then came back in an explained that he was confident that I was having anxiety issues and that I should try and relax, but not to worry about it. When he was leaving I said, "How far along are you in school?" He said, "Well, actually I'm just starting my second year of school." I'm not sure if that is medical school, or school in general.

He left, and then a girl came in and started to take my information, gave me a printout of my diagnosis, and then it occurred to me I wasn't in fact going to see the doc at all. I thought, "Well, screw it, I'll pay my hundred bucks and go to a different doctor." I'd asked about price before my appt and was told that they couldn't tell me specifically, and then after, that it couldn't be figured right then because of the ECG, that I would be billed. But I recently received my bill for $954.00.

I've never known an urgent care to charge so much, but $400 of that is a "new patient physician consult."

The next doctor I found did an actual assessment and ecg and discovered a dangerous medicine interaction that was most likely causing my tachycardia issues and could have been really dangerous if left undiscovered...

I'm guessing that this medical student doesn't have any legal level of certification, so I'm wondering, as I wait for my next phone call to fight my bill, if it's even legal for him to treat patients without direct oversight? And are there morals and ethics surrounding the doctor billing for his physician level services yet sending his medical student in instead, and only?

And lastly, has anyone EVER been billed a grand for a quick care/urgent care visit???
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#2 Doczilla

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Posted 03 December 2012 - 05:48 PM

No, yes, and no.

A medical student does not have an MD degree, and therefore no license. They cannot bill. A first year RESIDENT (and that may be why they identified themselves as a student) can see and treat patients, but not independent of oversight by an attending (typically has to review each case directly, as well as any diagnostic adjuncts. Many don't necessarily see the patient themselves.). They also have no license until they have completed their first year of residency, Step 3 of the USMLE, and complete the state's licensing process.

Billing for this without being seen by a physician is fraud. Without a physical examination, you can't bill at that level either unless you are a psychologist. A level 5 coding requires examination of a certain number of body systems, history points to include medical, family, and social history, and a review of several body systems (ROS). Call the billing company and explain this, and they should write it off. If they push back, mention the fact that an actual doctor found it was due to a dangerous condition, and that should also make them lean toward writing it off.

What probably happened is that the doc probably got busy, staffed the patient with the student, then didn't see you though the medical student thought he did.

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#3 Arctickat

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Posted 03 December 2012 - 05:50 PM

Sorry bud, I can't speak to the legal issues, but I would be irked to be billed for a physician consult when I was never exposed to a physician. I'm sure that your bill will likely go away though when the Urgent Care Clinic is informed of the results from your second opinion.

Edit: 'Zilla's response came in as I was typing up mine. He seems to have good facts. :)

Edited by Arctickat, 03 December 2012 - 05:52 PM.

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#4 Ruffmeister Paramedic

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Posted 03 December 2012 - 06:05 PM

I already responded via facebook.
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#5 spenac

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Posted 03 December 2012 - 06:37 PM

Just hope you are ok man. Hopefully they trash the bill.
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