Lowden Plan --> Bartering w/ Medical Services

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The pdf link has a pretty good article on the topic of barter and medical care.http://www.uoworks.com/pdfs/feats/BARTERING.pdfBlast from the past -- 2003!

Locke, MD---------- Forwarded message ----------

Date: Sun, May 18, 2003 at 11:14 PMSubject: [practicemgt] Bartering w/ Medical ServicesTo: Practice Management Issues Dr. Mnabhi asked about bartering w/ Medical Services.

There was an interesting article in a magazine called Unique

Opportunities.

http://www.uoworks.com/

Check out...

http://www.uoworks.com/content125.html

Or open the article directly at...

http://www.uoworks.com/pdfs/feats/BARTERING.pdf

I didn't re-read the article, but as I recall, their general feeling was

that under special circumstances it might be OK.

For example, I'll give you a complete physical if you do some landscaping

on

my yard.

Where it gets dicey, is when say...I'll treat your gout episode if you do

" x " ...but what happens the next time they come in with gout. Do you have

to

barter again?  Maybe you don't need anymore landscaping, but that's all

they

have to barter, how does the patient barter then?

I think in the old days, when it was primarily episodic care, bartering

probably worked better.

Patient breaks arm. Doctor fixes it. Patient gets well and pays with milk

and eggs. End of story.

But how do you barter care for cholesterol management...which is ongoing

and

requires labs, meds, etc?

Also, there can be a feeling of inbalance of power. For example, if the

patient has an ongoing medical problem that could kill him without

treatment. You are the only doc who will accept barter in the town (and

the

patient really doesn't have any other way to pay for it). The doctor

potentially has the balance of power to extract inappropriate barter fees

from the patient by threatening not to continue to care for the patient if

the patient doesn't barter more and more value.

I attended an ethics talk at one of our medical society meetings recently.

This barter topic was brought up. One of the docs had bartered some

medical

care for some work around the house.

The general feeling was that this probably wasn't good from a malpractice

standpoint. I think the ethical issue wasn't so much the problem, but I

can't remember the specifics of why it was felt to be a problem.

On the other hand, wouldn't it be nice to barter dental cleanings for your

family by offering to see a dentist's family for routine and acute care.

Both of you probably make out OK.

Interesting area of discussion. I'm sure many of us are bartering whether

we

call it that or not.

Many of us have probably seen a person who did us a favor for free after

they did us a favor at another time.

For example, someone goes above and beyond to fix something that needs

fixing...if they don't have insurance, you might see them for free the

next

time they come in for a sinus infection.  It's sort of a form of thanks,

but

also, you are subtly bartering their good service last time in hopes they

will give you great service next time.

Just my thoughts, I could be wrong.  :-)

Locke, MD

Basalt, CO

Graduate 1994

5 Years in Air Force (Texas, Germany)

Private Group Practice since 1999

Job Share w/ Wife

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