Quantcast

some bad disability law here

$tinkle

Expert on blowing
Feb 12, 2003
14,591
5
freakonomics: The Price of Disability Law
We wrote a column a while back about a variety of powerful unintended consequences.

One example was the Americans With Disabilities Act, and we told the story of a Los Angeles orthopedic surgeon named Andrew Brooks. When a deaf patient came to him for a consultation, he realized that the A.D.A. required him to hire a sign-language interpreter for each visit if that’s what the patient wanted. The interpreter would cost $120 an hour, with a two-hour minimum, and Brooks wouldn’t be reimbursed by the insurance company:

That would mean laying out $240 to conduct an exam for which the woman’s insurance company would pay him $58 — a loss of more than $180 even before accounting for taxes and overhead.
Brooks saw the patient and paid for the interpreter out of his pocket; fortunately, she didn’t need surgery. But the incident made him conclude that if doctors have such a strong financial disincentive in such a case, “this kind of patient will end up getting passed on and passed on, getting the runaround, not understanding why she’s not getting good care.”

One can expect Brooks’s prediction to come true a bit more often in light of a recent lawsuit in which a New Jersey rheumatologist was required to pay a $400,000 settlement, including punitive damages, to a deaf patient. From MedicalJustice.com:

The court concluded Dr. Fogari’s transgression was failure to provide an interpreter for his deaf patient. Such an interpreter apparently costs ~$150 to $200 per visit. And Medicare only reimbursed ~$49 per visit. Apparently, Dr. Fogari communicated by exchanging written notes with the patient assisted by family members.

Dr. Fogari treated the patient for lupus and care mainly involved follow-up visits monitoring her medication. The patient experienced no complications and there were no allegations of negligence. The patient transferred her care to another doctor.
Medical Justice, which is dedicated to “relentlessly protecting physicians from frivolous suits,” does find a silver lining in the disability law:

If you, as a small business owner, hire an employee with a recognized disability, you are potentially eligible for tax credits in the thousands. And, if that individual understands sign language, you have killed two birds with one stone.
That said, it is hard to believe that this kind of lawsuit won’t make more doctors do their best to avoid seeing similar patients in the future. In which case a law designed to prevent discrimination will, yes, encourage discrimination.
i guess the biggest problem i see is the dr is required to offer his professional service, and nothing more
 

ire

Turbo Monkey
Aug 6, 2007
6,199
4
I'm surprised the responsibility of the interpreter didn't fall on the patient
 

sanjuro

Tube Smuggler
Sep 13, 2004
17,412
0
SF
So the doctor is stuck with out of pocket costs...

and the problem is what?

p.s. i would have bought in a computer with voice recognition...
 

$tinkle

Expert on blowing
Feb 12, 2003
14,591
5
So the doctor is stuck with out of pocket costs...

and the problem is what?
the patient is no longer the customer

remember, a practice is a business. isn't like this is a VA hospital where the tax payer gets stuck w/ the costs.

i still don't get how unfunded mandates come to pass & have the full force & effect of law
 

Toshi

Harbinger of Doom
Oct 23, 2001
27,299
2,120
there was quite a bit of discussion of this on the "doctor boards", a la our ridemonkey. the consensus is that alternative means of accommodating patients should be acceptable in most circumstances, and that providing an in-person interpreter at the practice's cost is not necessary across the board.
 

$tinkle

Expert on blowing
Feb 12, 2003
14,591
5
there was quite a bit of discussion of this on the "doctor boards", a la our ridemonkey. the consensus is that alternative means of accommodating patients should be acceptable in most circumstances, and that providing an in-person interpreter at the practice's cost is not necessary across the board.
while i agree, rm boards != results of malpractice suits/a.d.a. violation

the law is fuxored, if only by lack of proper funding/compensation.
 

Cant Climb

Turbo Monkey
May 9, 2004
2,687
10
because to pass the savings on to you, the doctor will write it out themselves...and no one would be able to read it anyway...

It'd be about as effective as me throwing up signs in east L.A.
Really don't see the doctor charging more at all....

The patient would have to sign off on it maybe....
 

Silver

find me a tampon
Jul 20, 2002
10,848
0
Orange County, CA
Fogari treated Gerena for lupus for about 20 visits, stretched out over 20 months. He would sometimes exchange written words with her civil union partner, Lourdes Torres, who had better written English skills, and he also communicated with Gerena through the couple's 9-year-old daughter.

That sounds like malpractice to me...I have some sympathy for the doctor, but trying to convey medical information through a 9 year old is just stupid.

http://www.law.com/jsp/article.jsp?id=1202425326286
 

X3pilot

Texans fan - LOL
Aug 13, 2007
5,861
1
SoMD
Fogari treated Gerena for lupus for about 20 visits, stretched out over 20 months. He would sometimes exchange written words with her civil union partner, Lourdes Torres, who had better written English skills, and he also communicated with Gerena through the couple's 9-year-old daughter.
So, apparently we aren't going to try and harvest any jokes with a crippled, deaf, Latino lesbian single mother???