Shortage of Specialists in Emergency Rooms
In today’s emergency rooms, it has become routine to not be able to see a specialist for the ailment a patient came in for. Many times, except in absolute emergencies, the patient’s pain will be treated and they will be referred to a specialist’s office and directed to make an appointment for follow up care. Many issues play into the reduction of specialists available in the emergency room and range from the need to pay specialists for their time on call to many specialists choosing to be exclusively office-based and not participating in emergency room call at all.
Differences in Organizations
In a situation such as specialist shortages, ...view middle of the document...
“In addition to the financial and resource costs associated with transferring and treating patients, Rao found that hospital ratings suffer as a result of specialist shortages. Twenty-three percent of the hospitals experienced a loss or downgrade in trauma center designation levels as a result of on-call specialist coverage problems,” (Robert Wood Johnson Foundation, 2011).
Perspectives and Responsibilities of Financial Management
From the financial perspective, management must look at the costs associated with transferring patients out to facilities with specialist coverage versus paying the stipends or contracting with specialists to keep patients in house. The money lost due to transferring a patient includes a possible hospital stay, diagnostic testing, possible surgery charges, etc. If this money outweighs what it would cost to somehow secure specialty coverage, management should look further into the issue.
Rules and Regulations that Need to be Addressed
When attempting to financially secure specialists to take emergency room call, financial management needs to take into account the financial implications that will affect the hospital. In addition to this, management must also be take in account the physician’s requirements as outlined in the hospital medical staff bylaws, Medicare requirements, and any other contracts and/or agreements the specialist may have. One specific bylaws amendment at many hospitals is the requirement to take call to be a member of the medical staff. If this is in the Bylaws, management does not need to financially support any specialist to take call. On the other hand, if this requirement is not in the Bylaws, then financial support is appropriate. Management must also be cognizant of the federal Anti-Kickback Statute. The Anti-Kickback Statute “states that no person may offset or request, give, or receive remuneration in exchange for a referral for a good or service that may be reimbursed under a federal healthcare program,” (Cleverley, Song, Cleverley, pg. 91). An example would be for management to agree to refer all orthopedic patients to a specific orthopedic surgeon on their medical staff if he agrees to take call for the...