I am an OBGyn in a group practice. We are employed by a nonprofit. Basically, we don’t turn anyone away. The only other group in town providing OBGyn services is a private practice that can pick and choose patient care based on insurance. Our hospital is a third entity. As both groups have privileges at the hospital (only hospital in town), we divide the unassigned patient call based on the ratio of providers in each group (4 docs in one group, 3 in the other) so we take an extra week of call every few months.
We have run into the issue of patients presenting to the ED or OB triage, either with a scheduled appt with us, or the “intent” of seeing us, and we have traditionally just taken care of them. Thus, this is the expectation from ED docs and nurses. Over the last year, the number of unassigned patients has increase significantly and the burden of taking care of our own patients, plus the unassigned has had us questioning which patients we really should take care of and which should go to the unassigned provider. (As a note, the private group is really taking very few new patients, most of these women don’t anticipate seeing the private group.)
I am wondering what the ethical or legal standard is for this, or if the is one. Does having an upcoming appointment with a provider establish a relationship that we are required to take the patient? I can’t imagine “the intent” to follow up with provider X being binding at all, but maybe other ppl have had other experiences.
If there are any resources I should be looking at, please point me in the right direction.
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