I referred a patient for a sleep study on the suspicion that his daytime somnolence and history of snoring might indicate sleep apnea, a treatable condition. What I received was a report of a consultation performed by the physician at the sleep clinic and his ordering of the same exam I had asked for. This upset me a bit but I accepted it as a sign of the times and the economy. In the medical field as in every other area of business, everyone is trying to make a buck and requiring a consultation prior to testing is that medical group's policy. I would require that I meet and examine a patient before preforming an outpatient catheterization procedure. (That's because it is an invasive technique with true risks, not just watching someone sleep!)
What really pissed me off, however, was the part of the consultation report where the physician examined the patient for signs of spinal stenosis due to his history of lower extremity pain and recommended an MRI scan! How convenient that his group happens to own and operate an MR scanner. Obviously this is a case of attempt for self referral and taking advantage of the patient. All I wanted was a simple sleep study but I got a sleep physician's consultation and recommendation that he return for an MRI to evaluate possible neurogenic claudication!
What the F---?
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