MAY 01, 2021
Question: A new patient recently scheduled an examination following an auto accident. The patient was worked up by our technician and told that an ophthalmologist would examine her after her eyes were dilated. At that point, my partner entered the room and sat down to begin the exam; he was then abruptly called into the hall by our office manager, and the patient’s lack of insurance coverage was discussed within the patient’s hearing. My partner did not re-enter the exam room, and the patient was told to leave and seek care in a nearby emergency room with her eyes dilated. This situation clearly should have been handled differently. What is the risk to our practice from my partner’s actions?
Answer: Your partner’s action potentially put the patient and your practice at risk. Starting a patient’s treatment and then refusing to continue that treatment because of inability to pay for services or fees could be interpreted as patient abandonment (depending on the nature of the patient’s injuries and the course of her recovery) and is a violation of Academy Code of Ethics Rule 2 (Informed Consent). Had the patient been fully informed that she would not be examined unless her financials were in order, it is doubtful that she would have agreed to this diagnostic medical procedure.
Ophthalmologists deserve to be compensated for services rendered. However, patients’ insurance coverage or ability to pay should be assessed prior to the patient entering the examination room. Furthermore, there exists a liability risk of patients being injured after dilation. Dilating drops are an essential aid to diagnosis; yet they are known to cause temporary vision problems related to glare, light, and contrast sensitivity.
Learn more at aao.org/clinical-education/redmond-ethics-center.
To submit a question, contact the Ethics Committee at ethics@aao.org.