Giving away patient model RESPONSES (1of 2)
Randy McFarland
Description
Collection
Title:
Giving away patient model RESPONSES (1of 2)
Creator:
Randy McFarland
Date:
10/15/2005
Text:
ORIGINAL POST
I have a question-
If a departing practitioner has his patients call me to request
their cast molds and test sockets, what is my obligation to the
patients?
Randy McFarland, CPO
Sunny Hills Orthopedic Services, Inc,
Fullerton, CA
To see what I decided to do, read after the last response.
Thanks for the following
RESPONSES
If the patient is requesting the mold or check socket you must be
careful in
explaining that the check socket and its use are not for the patient but
for
diagnostic purposes. You have to determine from the patient why he would
need something which in theory is not to be needed after their
prosthesis is
completed. If the patient tells you outright that he is going elsewhere
try
to convince him to stay with you. If the patient really want these
things
for themselves he can receive them but only after a release of all
liability
is signed by the patient and that will include voiding any warranties
that
may still be on their prosthesis and its parts. The voiding of the
warranties
would be based on the fact that if he is going to another facility for
adjustment
or repair you cannot be responsible for what they do. This has nothing
to do with a
patient who seeks assistance when they are out of the area and a
colleague does a
emergency repair to keep them going. As far as the other items are
concerned I never
give a patient a test socket but a cast I have. I always have them sign
a release.
Ethically speaking this practitioner should never have asked his
patients to do this
and if he needs them to do this then he isn't a very good practitioner.
In the end the patient has the right to ask and you have a right to deny
the
request on the grounds that these items were used in the fabrication of
a
prosthesis and are normally discarded after the prosthesis is completed.
I believe your molds are proprietary but I am not an atty.
With a Prepaid legal membership for your business you could call an
atty. anytime (even several time a day) for legal advice from the top
lawyers in your area and have a: legal dept., Human Resources dept.,
Marketing dept., technology dept., and Accounting dept. for as little as
$2.50 per day. Call me if you want to know more.
From previous experience - and from legal opinion - the patient has the
rights to all that pertains to her/him that you have in your possession.
Inform them that they have already been disposed of.
I would find a way to not give it to them. If you billed them for a
test socket though, does it belong to them? I don't think that the fees
associated with a test socket would justify this. I definitely don't
think that a cast mold would belong to them ever. I would make sure
that the test sockets disappeared quickly.
They are a fitting tool and unsafe for the patient to have. You are the
casting practitioner and the patient could be harmed by another
practitioner trying to fit your technique. Liability is too great to
place yourself in the chain of evidence should something go wrong.
Sounds like you have a sticky situation.I personally believe the molds
and check sockets are the property of your company. The molds and check
sockets are basically tools used to fabricate their prostheses. I think
you will probably have to decide this on a patient by patient basis. If
I were in your shoes, I would probably make it a policy that if you keep
a particular mold on file, that it is for your company use only. The
only exception would be if a patient was moving out of the area and
really wanted to take their molds with them.
If the prosthesis has been completed and paid for, then they are the
property of the patient. Giving them to the patient will be good PR for
future care. If the prosthesis has not been delivered and the
prosthetist is trying to save time, then he/she or his/her company
should reimburse your company for them since technically they are still
in your control. Again, take the high road and think good PR.
Great question for an attorney. I guess it comes down to whether or not
that
the molds and/or test sockets are considered a part of the patient
record,
which they CAN request. Further, since we bill the patient for a test
socket, don't they own it already? Let us all know when you find out.
The molds and test sockets belong to the facility that billed the
insurance
company for the service of fabricating the prosthesis. You do have to
send
progress notes and measurement sheets if requested, but I would require
a
written release.
Treat the pt. with respect and honor their request. Ask that they cover
the
fright, if you still have what they are asking for. This is easy to do
if
you have receive payment for these items you have fabricated.
none...they were destroyed when the practitioner left as you cleaned
up after him
If the patient has paid for the items, then it theirs, but at the same
token it your property until it is paid for.
A question to go with your question, were they paid for? If they were,
they should be property of the patient. If they were work in progress
without being paid for and someone else will be finishing the fitting in
your office then you should keep them and let the patient know that they
belong to the office until they are paid for.
I WOULD THINK THAT SINCE THEY PAID FOR THE TEST
SOCKETS THAT TECHNICALLY THEY WOULD BE SOMETHING THAT
THE PT. WOULD BE ALLOWED TO KEEP. I AM SURPRISED THAT
YOU KEEP ALL OF THESE I KNOW I DO NOT.
It seems to me that they should be finished up and billed through your
facility. If they want to go to him for their next ones that's fine, but
if he started work under your roof with your overhead expenses it seems
like he has an obligation to finish it where he started.
Of course, using your molds uses your work, and he gets it for free -
and,
if it's like one that happened to me in my practice in Ohio, he'll be
making
the prosthesis with your supplies and some of your tools!
Of course, using your molds uses your work, and he gets it for free -
and,
if it's like one that happened to me in my practice in Ohio, he'll be
making
the prosthesis with your supplies and some of your tools!
If you have a non-compete clause with the practitioner you are under no
obligation to supply these items. These are patients of your facility
not the practitioner. He should not be allowed access to the files
either.
I would definitely not give casts away, as these are not something that
a patient purchased, they purchase a check socket. If that is
available, I'm not sure what the answer is. I would offer to sell them
a finished socket, or the cast at a hefty price, as this is the majority
of what goes into a finished socket, and was done on your time and while
he was working for you. Offer a cast at the going rate of a finished
socket less the cost of having a socket made from a cast sent to central
fab, as this is all that is left to do. I'm talking L-code prices for
all the codes associated with a complete socket, less $400 or so that it
may cost you to have it fabricated. What do you have to lose? A
patient that is already lost from your practice.
(continued in next E mail)
I have a question-
If a departing practitioner has his patients call me to request
their cast molds and test sockets, what is my obligation to the
patients?
Randy McFarland, CPO
Sunny Hills Orthopedic Services, Inc,
Fullerton, CA
To see what I decided to do, read after the last response.
Thanks for the following
RESPONSES
If the patient is requesting the mold or check socket you must be
careful in
explaining that the check socket and its use are not for the patient but
for
diagnostic purposes. You have to determine from the patient why he would
need something which in theory is not to be needed after their
prosthesis is
completed. If the patient tells you outright that he is going elsewhere
try
to convince him to stay with you. If the patient really want these
things
for themselves he can receive them but only after a release of all
liability
is signed by the patient and that will include voiding any warranties
that
may still be on their prosthesis and its parts. The voiding of the
warranties
would be based on the fact that if he is going to another facility for
adjustment
or repair you cannot be responsible for what they do. This has nothing
to do with a
patient who seeks assistance when they are out of the area and a
colleague does a
emergency repair to keep them going. As far as the other items are
concerned I never
give a patient a test socket but a cast I have. I always have them sign
a release.
Ethically speaking this practitioner should never have asked his
patients to do this
and if he needs them to do this then he isn't a very good practitioner.
In the end the patient has the right to ask and you have a right to deny
the
request on the grounds that these items were used in the fabrication of
a
prosthesis and are normally discarded after the prosthesis is completed.
I believe your molds are proprietary but I am not an atty.
With a Prepaid legal membership for your business you could call an
atty. anytime (even several time a day) for legal advice from the top
lawyers in your area and have a: legal dept., Human Resources dept.,
Marketing dept., technology dept., and Accounting dept. for as little as
$2.50 per day. Call me if you want to know more.
From previous experience - and from legal opinion - the patient has the
rights to all that pertains to her/him that you have in your possession.
Inform them that they have already been disposed of.
I would find a way to not give it to them. If you billed them for a
test socket though, does it belong to them? I don't think that the fees
associated with a test socket would justify this. I definitely don't
think that a cast mold would belong to them ever. I would make sure
that the test sockets disappeared quickly.
They are a fitting tool and unsafe for the patient to have. You are the
casting practitioner and the patient could be harmed by another
practitioner trying to fit your technique. Liability is too great to
place yourself in the chain of evidence should something go wrong.
Sounds like you have a sticky situation.I personally believe the molds
and check sockets are the property of your company. The molds and check
sockets are basically tools used to fabricate their prostheses. I think
you will probably have to decide this on a patient by patient basis. If
I were in your shoes, I would probably make it a policy that if you keep
a particular mold on file, that it is for your company use only. The
only exception would be if a patient was moving out of the area and
really wanted to take their molds with them.
If the prosthesis has been completed and paid for, then they are the
property of the patient. Giving them to the patient will be good PR for
future care. If the prosthesis has not been delivered and the
prosthetist is trying to save time, then he/she or his/her company
should reimburse your company for them since technically they are still
in your control. Again, take the high road and think good PR.
Great question for an attorney. I guess it comes down to whether or not
that
the molds and/or test sockets are considered a part of the patient
record,
which they CAN request. Further, since we bill the patient for a test
socket, don't they own it already? Let us all know when you find out.
The molds and test sockets belong to the facility that billed the
insurance
company for the service of fabricating the prosthesis. You do have to
send
progress notes and measurement sheets if requested, but I would require
a
written release.
Treat the pt. with respect and honor their request. Ask that they cover
the
fright, if you still have what they are asking for. This is easy to do
if
you have receive payment for these items you have fabricated.
none...they were destroyed when the practitioner left as you cleaned
up after him
If the patient has paid for the items, then it theirs, but at the same
token it your property until it is paid for.
A question to go with your question, were they paid for? If they were,
they should be property of the patient. If they were work in progress
without being paid for and someone else will be finishing the fitting in
your office then you should keep them and let the patient know that they
belong to the office until they are paid for.
I WOULD THINK THAT SINCE THEY PAID FOR THE TEST
SOCKETS THAT TECHNICALLY THEY WOULD BE SOMETHING THAT
THE PT. WOULD BE ALLOWED TO KEEP. I AM SURPRISED THAT
YOU KEEP ALL OF THESE I KNOW I DO NOT.
It seems to me that they should be finished up and billed through your
facility. If they want to go to him for their next ones that's fine, but
if he started work under your roof with your overhead expenses it seems
like he has an obligation to finish it where he started.
Of course, using your molds uses your work, and he gets it for free -
and,
if it's like one that happened to me in my practice in Ohio, he'll be
making
the prosthesis with your supplies and some of your tools!
Of course, using your molds uses your work, and he gets it for free -
and,
if it's like one that happened to me in my practice in Ohio, he'll be
making
the prosthesis with your supplies and some of your tools!
If you have a non-compete clause with the practitioner you are under no
obligation to supply these items. These are patients of your facility
not the practitioner. He should not be allowed access to the files
either.
I would definitely not give casts away, as these are not something that
a patient purchased, they purchase a check socket. If that is
available, I'm not sure what the answer is. I would offer to sell them
a finished socket, or the cast at a hefty price, as this is the majority
of what goes into a finished socket, and was done on your time and while
he was working for you. Offer a cast at the going rate of a finished
socket less the cost of having a socket made from a cast sent to central
fab, as this is all that is left to do. I'm talking L-code prices for
all the codes associated with a complete socket, less $400 or so that it
may cost you to have it fabricated. What do you have to lose? A
patient that is already lost from your practice.
(continued in next E mail)
Citation
Randy McFarland, “Giving away patient model RESPONSES (1of 2),” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/225552.
