Home Forums Discussions General Discussion Treating Staff and their families

I am just curious how you all feel about being a primary care provider for your staff and/or their families/kids.

I do that. Their choice if they want me to care for them or their family.

Greg

We have lots of clients that do that. In fact, many of them send us a list of patients whose claims they want written off after insurance has resolved because they are a friend/family member/etc.

I actually had to automate that process.

JamesNT

We do it also. We charge insurance, then write off the balance. Since we have an HSA for the office, we never actually get any payments, but it's in our self interest to keep them healthy.

Since we are on the subject of insurance, etc. I apologize if this is a hijack, and I will delete it if it is, but what do you do if you are seeing a six-year-old and an eight-year-old, and for whatever reason, the former has Medicaid and the latter doesn't.

You need to order Zithromax and a nebulizer with albuterol for the 8 yo who has no insurance. The parent asks you to prescribe it under the 6 yo's name. I guess this could be either why not, Medicaid is a rip off anyway to fraud.

Anyone.

And, yes, I do treat my staff. And, the above does come into play as well.

It gets a bit ticklish at times and I have to wear my employer hat at times and Dr hat at others, but can't recall any major issues over the years of doing this. It is mutually beneficial as I see it.
Just for the record I am responding to Bill's initial question.

I have had people ask me to write for another patient, but have calmly explained that it is against the law and that I cannot help them. Have never had anyone really upset after I explained it - I have found many ways to help patients I think I have even given away a nebulizer, a walker, etc.......

I say no to prescribing in another person's name. I don't care a bit about "protecting" their insurer, they screw us docs on a daily basis. But it falsifies their medical information, and could lead to errors, which we need to prevent.

way way back in the days of locally owned pharmacies, I knew of one that used to give patient what the Dr. ordered but then billed Medicaid for what was covered..along the same line as the Nebulizer ?? I guess

We still have this pharmacy with the slogan, "Our family serving yours." Patients either love them or hate them. Some like to shop while they wait, but here you kind of stand and wait.

But, they are the only one with nebulizers and tubing and walking boots, etc., and the only ones who compound and do extemperaneous solutions. They give self pay a break. Some meds which are $25.00 at Wal-Mart are $7.00 at this pharmacy. The pharmacists are extremely knowledgeable, and we call them all the time with questions.

Better yet, stock your own commonly prescribed generics and dispense them yourself like I do. If I have a patient that cannot afford a script, it is then my business alone if I want to give them a supply or sell it to them at an even more discounted price. You would be surprised just how cheap most of our common drugs are to buy wholesale.

You don't have to say, but what is the average markup on something like Nexium (no generic) or Prevacid?

We tried pre-packaged generics but couldnt even break even on them when Meijers and Kroger give it away for free. Meijers is giving away free generic atorvastatin. We take care of employees/families and bill insurance and write off the rest. I buy nebulizers, and they always seem to get loaned out and never come back. I by tubing for 50 cents to 1.00 a set - it is a great give-away...but I now ask for patients to bring me a cold diet-7up if they want an extra by the way question answered...you have to draw the line somewhere...

If you ask your patients to bring Diet Cokes, coffee, etc., they will.

Home made huckleberry pie if you live in Montana!!!

I treat my ONE staff member as she needs it. I do sports med and all...but here is how i would deal with it.

first off, we dno't offer insurance as one of the benefits at this time...so I would just see her if she needs it and give her advice...i tell her that if we need more like MRI/CT/Labs then we have to do an official visit.

I would not write scripts in someone elses name...remember under questioning, if it is you or them, they will pick themselves every time...

i don't do primary care but i think if i still did, and my staff needed it, i would have no issue with it as long as i billed insurance and wrote off the rest.