Patient incurs extra fees for asking doctor too many questions

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by CBS News

CBS News

Posted on October 25, 2012 at 10:02 AM

(CBS News) -- A Minnesota woman is bringing attention to hidden fees in medical bills. 

Susan Krantz says her doctor charged her an extra $50 for asking questions during her annual physical.

But it's not just Krantz that's noticing these fees. It's becoming a problem for patients all over the country. CBS medical correspondent Dr. Jon LaPook said on "CBS This Morning" that it all sounds crazy, but it's crazy -- with an explanation.

Insurance companies, he explained will pay for a once-a-year preventative visit that covers what's happened in the last year and pre-existing conditions. However, if something new comes up that takes time to discuss, the doctor will charge again.

"The patient should be warned (they'll be charged) beforehand," LaPook said.

CBS station in Minneapolis: Questions can trigger split visit charge at doc's office

Asked why this is happening, LaPook said it's because of "perverse incentives."

"In this country, doctors are paid for doing stuff to patients, instead of providing health," LaPook said. "So to give you an example, I'm an internist, general doctor and a gastroenterologist. If you come in complaining of...heart burn, I can take a long time talking to you about your history, what's going on in your life, maybe you're aggravated about this job you have, maybe I don't need to do any procedure if I could just talk to you or I can do a procedure. The insurance company will pay me for a lot more for doing a procedure on you than for spending time and figuring out what's going on."

Doctors should get paid for their time, but, he said, "not under a system where the meter is running."

"As a doctor, I want to encourage you to tell me everything," he said. "I want to avoid that 'by the way' moment as you're leaving. 'Oh, by the way, I have crushing chest pains.' My colleagues may hate me for this, but there are systems like in the Cleveland Clinic where people are on salary, and there's no incentive whatsoever for just doing procedures for ordering stuff. That may not be the only solution, but we have to figure out a way where doctors are now encouraged for providing health to the patient rather than just doing stuff to them and ordering procedures."

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