Write to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262
In the recent Academy Bulletin (October 1998) the DOJ (Department of Justice) was quoted as saying the union interfered with independent negotiations between the insurance carrier and the provider. Since when has an insurance company 'negotiated' with any individual physician or group of physicians? Here in Phoenix, where the market is nearly 75 percent managed care, you are told to take it or leave it. BCBS has said there is no negotiating the terms of the contracts it offers and they dictate all the terms including a 20 percent withhold that brings their reimbursement to well below Medicare levels. The federal government needs a good dose of reality before it comes down on physicians for trying to protect their livelihood.
Sign your site
Concerning recent articles in the Bulletin on the 'Sign your site' program, I agree strongly that hospitals should identify the limb to be operated on. I disagree strongly with the methods that are being beautifully promoted by the Academy.
Why write on the area you are going to operate on when there is even a tiny chance of contamination? Is it not just as easy to write on the opposite side?
How does the nurse know what the signature means? With the AAOS method, some rotating nurse is going to get confused. Logic tells me that you scribble and mess up the nonoperative site rather than the area you work so hard to clean.
Why not simply write 'NO' or 'NOT' on the opposite leg?
Ronald P. Grelsamer, MD
New York City, N.Y.
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