6 Nonbillable Events That Paid Me Handsomely
Waltman, Richard E., Medical Economics
A consultant urged the author to avoid doing anything he couldn't bill for. His response: Those encounters can be the most rewarding kind.
Our medical group recently hired a billing expert to help us improve coding and increase charges. He urged us to avoid "nonbillable encounters" and to charge for whatever we did. "Keep the meter running at all times;' he said. "You are highly trained professionals, and deserve to be paid for what you do."
This consultant does a very good job. He knows his material and presents it clearly. I picked up a few tips from him that will probably help my bottom line, and I am grateful for that.
But he missed a key point. Some of the most gratifying moments we physicians enjoy have nothing to do with money. Making a great diagnosis, intervening quickly and seeing a patient recover, having a patient come back to see us in the office after a difficult hospitalization, providing support to a dying patient-experiences like these give us compensation that cannot be measured in dollars and cents.
Here are some recent earnings of mine that won't appear in my paycheck but are, simply put, priceless.
Sara Reilly (I've changed all the names) is an 80-year-old woman, relatively new to our practice, with controlled hypertension and advanced arthritis. As I stood to leave the exam room after a recent visit, she asked whether I could answer a "stupid" question for her. She wanted to know whether a man who is dying of a stroke experiences pain.
I sat down again, realizing my morning schedule was now shot, and she told me how she had cared for her husband at home after his stroke. She felt she had done a good job, but she was upset because "I wasn't there at the end."
She explained that she was sitting next to his bed, kissed him, told him she loved him, and then fell asleep in her chair. When she woke up, he had passed on. She told me that in the six years since his death she had felt that she'd failed to comfort him in his last minutes. She worried that he might have felt pain that she didn't help him with.
I explained that he likely hadn't experienced any pain, but had had a comfortable passing. I also reminded her that the last words he'd heard in his life were "I love you" and that the last person he'd seen was his wife of so many years at his side. I told her she had provided him a loving and gentle death, the way we all want to go, and that she had done a great job for him.
Mrs. Reilly cried, then smiled and asked if she could give me a hug. And a great hug it was. A week later I received a note from her. She said she still hated taking her blood pressure medications and still had a lot of pain from her arthritis, but that what I had told her had eased her mind and made her feel so much better. She told me she would never forget my kindness. And I won't forget her.
Mary Richardson is an 88-year-old woman with advanced arthritis
that forces her to use a walker. Her great-grandson invited her to his wedding in Hawaii, and though she was hesitant to make that long trip alone, I persuaded her to go.
She made the preparations, but then fell at home and fractured her pelvis a week before the trip. I hospitalized her for pain control and asked the physical therapists to give her double sessions each day. When she said she was still too ill to fly, I told her, "You'll be on that plane if I have to drive you to the airport."
We were able to get her well enough to use a wheelchair, and the airline agreed to help her. She made the trip. In the office two weeks later, back in her walker, Mrs. Richardson told me how glad she was to have been there for the ceremony, and thanked me for making her go.
A week later, I received a thank-you note from the groom. He told me that having his great-grandmother at the wedding was a wonderful blessing and that he would be eternally grateful for my concern. "You really must be a good doctor to be so concerned about our family" he wrote. …