Case Study: The Doctor Has Had It with the Paperwork
Mr. Dede is a 53-year-old patient with diabetes. His doctor prescribes a new glucometer for his diabetes management that is much easier to use and requires a much smaller blood sample. When he takes his prescription to the pharmacy, the pharmacy technician tells him that his health insurance requires paperwork to be completed by his doctor before they will allow payment for the device. Mr. Dede comes back a couple of days later saying that his doctor said the pharmacy has to complete the paperwork. The pharmacist calls the doctor to explain that the insurance company specifically prohibits the pharmacy from completing that kind of paperwork. The insurance will only accept the paperwork from the doctor who prescribes the device. The doctor responds, “I’ve had it with the paperwork. I am not doing it,” and hangs up.
Discussion Questions
Completing preauthorization forms, referrals, letters, and other paperwork from other entities take time from the doctors and other health professionals; they are not paid for the time they spend completing such paperwork. However, it may still be part of their responsibilities.
- Does the doctor have the right to refuse completing this paperwork?
- What are the ethical implications of the doctor refusing to complete the paperwork, for the doctor and for the pharmacist? Explain using the specific Sub-competencies of the Core Competency Values/Ethics.
- Besides completing or not completing the paperwork, are there other alternatives the doctor has to help Mr. Dede obtain a glucometer?
- If these individuals where working as a collaborative team, which actions could they take to have a positive outcome for the patient? What could the doctor, pharmacist, patient, and insurance company do?
