In the last “Chränzli”, my colleagues once again let off a lot of steam.
Then a physician reported the following annoyance: One of his patients has been suffering from chronic constipation for years. The colleague repeatedly prescribes the troubled man a drug that regulates bowel activity. After a few weeks, he receives mail from his trusted medical colleague. The latter informs him that there is a limit for the prescribed medication and that he should please answer the enclosed questions so that the obligation to pay benefits can be checked. Slightly annoyed, my colleague complies with this request, answers the questions and sends the letter to the medical officer. After a few days, he receives a negative reply. This annoys the colleague. As he tells the story, he flies into a rage and rants about the fact that there are apparently simple clerks deciding on behalf of the medical officer. This could not go on, he wanted to talk to the medical officer personally.
A colleague agrees with him and reports her annoyance with Spitex prescriptions. She, like most of us, is always receiving testimonials to sign. The colleague reports full of horror that she has to sign cost estimates of over 9000 francs. At one point, he said, he was charged for putting on and taking off compression stockings every day and for applying a compression bandage. Their complaint then led to the fact that the costs turned out almost 3000 francs lower. But the costs are still far too high, he said.
Another colleague adds that she has to sign a lot of BESA forms and her case costs go up because of that. And so case after case followed case.
My approach in these cases is very easy on the nerves. In the first case, I would also have filled out the certificate to the best of my ability and promptly returned it. I would have been surprised about the negative decision, but certainly not annoyed. I would have referred the patient to the patient center so that he could be helped to get justice.
I sign the Spitex regulations, BESA and Rai/RUG certificates without reading them.
Why, you ask? Quite simply: I cannot judge them materially correctly at all. In fact, the clarification of the need is carried out by specially trained nurses. I therefore only provide a pro forma signature. The dispute about care planning and the resulting costs should be settled by Spitex, health insurance and the patient without me.
Yours sincerely, Josef Widler, M.D.
