Question

(A. Based on your analysis of the above, which plan(s) do you think he is targeting for his revenues?

(B. What are the advantages and disadvantages for the consumer in this scenario?

(C. What are the legal and ethical obligations Dr. Jones has to his patients and how do they apply to this case?

Furtherm cework-Case for Chapters 9 and 10 Dale Buchbinder DISC outpatient vascular surgical procedures center attached Dr. Jones develops an He equips the center with a fluoroscopy unit, and all the requirements for asi to his of operating room have been maintained. He hires a nurse anesthetist to he patients. In addition, he has a small recovery area with a nurs to and monitor t patients postprocedure. He learns he can be reimbursed an up to $20.000 every procedure performed. He has decided that since his overhead is 40%-60%, the more procedures he performs, the higher his profit ratios will ere frm revascularization, he is Therefore, when Mr. Smith is in need of a lower extremity brought in for diagnostic angiogram. The angiogram reveals he has an superficial femoral artery stenosis on the lef side. These two lesions probabl the patient's symptoms. The patient returns the following week, and Dr. an iliac artery angioplasty with a balloon. In approximately 10 days, the for one of three procedures in which he has his superficial femoral artery also loe account for mms patient a balloon angioplasty The patient has now had three procedures totaling $60,000 in reven for these procedures was approximately 40%, providing a S36,000 profit. procedures been done in a regulated space (i.e., a hospital), the ph probably performed the diagnostic angiogram as well as the definitive angioplasties of ue. The overhead Had these physician would have external ilac and superficial femoral arteries at the same time. The physician' fes for those regulated procedures would have been approximately $2,000. Also, it is possible that in a facility the doctor would have chosen to at least place a stent or would have performed an atherectomy or even used a drug-coated balloon in one or both of these lesions. However in the free-standing outpatient vascular surgery center, the use of these devices would have greatly driven up the cost of the procedure and decreased the profits. It is not uncommon for these types of procedures to be performed in an unregulated space with no hospital quality control or supervision. While they drive up the cost of treating the patient, they are extremely profitable for the doctor. In order to gain dhis 512

Answer 1

A). The surgeon is targeting of preferred Provider organization plan. According to the plan, the insurance company encourages the network of providers offers services to its members at a discounted rate. The surgeon will get deductibles, and copayments by providing services to the members. In addition, treating the patient outside of the network provides additional profit for the physician.

B). One of the greatest advantages of this consumer is that waiting time is less. The patient had gone through the surgery very earlier whereas, in hospitals, he has to go through a long process and to wait for a long period. Secondly, the issues in insurance coverage are less because he has gone through a network of providers. The disadvantages are that the consumer undergone through the unnecessary procedures and risks of anesthesia every time. And also there is no emergency team to care if any complications arise. Another disadvantage is that the patient has paid a lot of money due to an increased number of procedures.

C). The legal obligation is that the surgeon doesn't have needed equipment, staffs, and emergency team if the patient has undergone a complicated situation during anesthesia or the procedure. The ethical obligation of the surgeon is made the patient undergo multiple procedures which result in massive expenses in the patient. These show the surgeons can lead to malpractices and adverse events.