- Joined
- Apr 11, 2008
- Messages
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Received this as a client bill heavy GI doc wants to send specimens out of our hospital facility where I have an exclusive contract. I've signed out thousands of peds GI cases, and the few that were difficult, expert opinion agreed with me. The obvious problems are there. I wonder if it would be a Stark violation. Basically I take it as jump in the lake we don't want you to read our path. My response is as nice as I could have put it.
Opinions? Critiques? I appreciate all of the insight the usual group has.
EMAIL TO ME:
Good afternoon, Dr. TORSED.
About a week ago, I discussed with the hospital CEO our decision to hire a GI trained pediatric pathologist. Though we feel that you are an outstanding physician, the specificity provided by this pathologist will best serve our patient population and provide continuity as we expand to other locations.
The CEO stated that your hospital has a contract with your group to provide all of their path work, but that I should speak with you regarding an exception for our patients. Our plan is to begin performing all of our procedures at your hospital, but in order to move forward with this, we would have to have access to our biopsies.
Please let me know if you are amenable to this arrangement, or if we need to discuss further. Of course, any arrangements that we make will remain completely confidential.
Again, thank you for all of your work on our patients’ behalf.
Sincerely,
XXXX, MD
MY RESPONSE:
Dear Dr. XXXX:
Thank you for the interesting e-mail. As I understand your e-mail, you wish to transport biopsies collected on site at my hospital to an off site location for processing and interpretation by a GI trained (but there is no board in GI pathology) pediatric pathologist (who rarely work outside of a large Children's type hospital or very large pathology group. This is a very peculiar arrangement.
I read from your email that you mention expanding to other locations, but then go on to say you will stay at our hospital, this is confusing.
I have an exclusive contract and will bill for the professional component for all anatomic pathology specimens and biopsies performed at our hospital. This is my livelihood, which I am sure you are aware. This is standard for all the hospital laboratories along the coast and in the nation as well as our radiology and anesthesia physician groups as well. I hope you can appreciate the gravity of the situation if every surgeon decided to send pathology to whoever they want because I made an exception, it would be a lord of the flies type of result and marked confusion. Thus the overall necessity of exclusive contracts.
Further, being the medical director of a high complexity laboratory I will not take the malpractice risk for myself nor this facility to have an off site, non privileged / credentialed pathologist to read the pathology work done that originates in my home hospital and is guaranteed by contract.
No other pathologists other than myself and Dr. YYYY have medical staff privileges at our hospital.
If there is any other options or discussion you would like to discuss that allows our facility to function as it should please feel free to communicate back.
TORSED
Opinions? Critiques? I appreciate all of the insight the usual group has.
EMAIL TO ME:
Good afternoon, Dr. TORSED.
About a week ago, I discussed with the hospital CEO our decision to hire a GI trained pediatric pathologist. Though we feel that you are an outstanding physician, the specificity provided by this pathologist will best serve our patient population and provide continuity as we expand to other locations.
The CEO stated that your hospital has a contract with your group to provide all of their path work, but that I should speak with you regarding an exception for our patients. Our plan is to begin performing all of our procedures at your hospital, but in order to move forward with this, we would have to have access to our biopsies.
Please let me know if you are amenable to this arrangement, or if we need to discuss further. Of course, any arrangements that we make will remain completely confidential.
Again, thank you for all of your work on our patients’ behalf.
Sincerely,
XXXX, MD
MY RESPONSE:
Dear Dr. XXXX:
Thank you for the interesting e-mail. As I understand your e-mail, you wish to transport biopsies collected on site at my hospital to an off site location for processing and interpretation by a GI trained (but there is no board in GI pathology) pediatric pathologist (who rarely work outside of a large Children's type hospital or very large pathology group. This is a very peculiar arrangement.
I read from your email that you mention expanding to other locations, but then go on to say you will stay at our hospital, this is confusing.
I have an exclusive contract and will bill for the professional component for all anatomic pathology specimens and biopsies performed at our hospital. This is my livelihood, which I am sure you are aware. This is standard for all the hospital laboratories along the coast and in the nation as well as our radiology and anesthesia physician groups as well. I hope you can appreciate the gravity of the situation if every surgeon decided to send pathology to whoever they want because I made an exception, it would be a lord of the flies type of result and marked confusion. Thus the overall necessity of exclusive contracts.
Further, being the medical director of a high complexity laboratory I will not take the malpractice risk for myself nor this facility to have an off site, non privileged / credentialed pathologist to read the pathology work done that originates in my home hospital and is guaranteed by contract.
No other pathologists other than myself and Dr. YYYY have medical staff privileges at our hospital.
If there is any other options or discussion you would like to discuss that allows our facility to function as it should please feel free to communicate back.
TORSED