Determining Whether to Extend Professional Courtesy to other Physicians

March 16, 2014

Traditionally, physicians do not charge each other for medical care. Unfortunately, this belief does not seem to be well understood by all doctors.

How does the saying go? A man that acts as his own attorney has a fool for a client. The same can be said about doctors treating themselves and their families. Traditionally, physicians do not charge each other for medical care so that we don’t try to take care of ourselves. Unfortunately, this belief doesn’t seem to be well understood by the newer physicians that I have personally been to lately.

It is frowned upon when doctors prescribe medications for themselves or their families (but I bet that many of you have done so over the years, and I am guilty of it as well!). In order to be a good clinician, we must maintain a certain level of objectivity, which is difficult with our own family members and is mostly impossible with ourselves. Thus, we should seek the help of other physicians for our personal health needs.

I also believe that we shouldn’t charge each other. Professional courtesy is part of being in the “club” and cost should never play into taking care of other physicians or their families.

But be careful! If you do not collect the copay from the physician for your services, you cannot charge the insurance company. This is fraud and you can get into big trouble! If you do send the bill to insurance, the insured patient (physician or not) must pay his copay or percentage as required by the insurance company.

If you are a physician and you visit another practice and that practice does not ask you for the copay at the date of service but later sends you the bill, you are obligated to pay it, per the requirements of your insurance company contract.

I like to discuss my professional courtesy policy with physician parents of my patients. For sick visits, I don’t ask for a copay (but I do not submit to insurance). For physical exams, in order to cover the cost of any vaccines, I ask for the copay and submit the bill to insurance. Since regular annual physical exams do not have copays as they are considered preventative care, I do not ask for a copay but I do submit the bill to insurance.

We now collect copays at check in, so by the time I see my physician parents’ children, the copay has already been paid. It makes things a bit more difficult to offer my services free of charge to these colleagues. If they have paid by check or cash I can easily refund their payment. A credit card requires issuing a credit to their card. I tell them at their next visit to let the front desk know that I give them professional courtesy.

I also let them know that I am giving them this benefit but cannot speak for my colleagues in the practice so only visits with me will be eligible for this courtesy (unless they make arrangements with other physicians in my practice). I do make a clearly visible note in the chart that one or both parents are physicians so others will know.

I also give my physician parents all my personal contact information (including cell phone). They should have access to me, even if I am not on call. This is important for developing a good relationship based on trust and accessibility. I have never had anyone abuse this option. Some of the physicians that I see spontaneously offer their private contact information. I feel awkward asking for it, however.

Recently, I have had quite a few doctor visits for myself. I have had to ask whether a medical practice offers professional courtesy, because as I have found out, it doesn’t seem to be automatically presented nor discussed.

Can I afford the copays? Yes, I can. But human nature being what it is, we physician patients will be more likely to seek other physicians’ opinions and treatment if there is no out of pocket cost involved. Most physicians will offer professional courtesy to me when I ask, but I do worry if they are following the rules and not submitting to insurance.

If another physician really needs to submit to insurance because finances are tight, all she needs to do is discuss it with me. I will totally understand. If she intends to offer professional courtesy to me, it would be good to let me know upfront. The key is communication.

As physicians, we should discuss our professional courtesy policies with our physician patients, whether or not we intend to offer it. And we should make sure to collect copays if we intend to submit to insurance.