The surgeon must take care to inform patients about the experimental equipment, and he must monitor their progress to help the Food and Drug Administration assess the device's safety and effectiveness. Medicare, the federal health insurance program for the elderly and disabled, covers many of the patients, and fulfilling its billing requirements can be a chore. To avoid trouble with the government, the doctors must thoroughly document the services they perform. When claiming reimbursement for a comprehensive exam, Whitten said, doctors ask patients about their smoking history and alcohol intake even though those questions may be irrelevant to the treatment at hand. Many of the precautions Whitten's staff observes are prompted by OSHA, the federal Occupational Safety and Health Administration as well as a healthy dose of common sense.
Doctors wash their hands between patients.
To comply with OSHA standards, the practice had a consultant prepare a safety manual, which notes that certain employees should get vaccinated against hepatitis or at least sign a form saying they have knowingly declined to be vaccinated. To comply with the Americans With Disabilities Act, which protects the rights of the handicapped, the office installed an extra-large bathroom capable of accommodating a wheelchair. One wall had to be moved six inches after the space was found to be too small. Like any small business, the medical practice is subject to myriad payroll requirements related to Social Security, income tax, unemployment insurance and the like. But Whitten's office cuts through the tangle by using a specialized firm to handle those tasks.