Court Opinion

ID: 9745077
Source: CourtListenerOpinion
Date Created: 2023-08-26 22:32:28.352686+00
Date Added: 2024-06-11T07:24:55.524604
License: Public Domain

NEAL, Presiding Judge,
dissenting.
I respectfully dissent from the majority opinion.
The linchpin for the justification of the charge to Rumple is the form signed by him which authorized the surgeon to “provide such additional services . . . as he . . . may deem reasonable and necessary including . . . radiology.”
The doctor who treated Rumple was an orthopedic surgeon, Dr. Eugene Doster, Jr. He testified that he was adequately trained to treat the fracture and interpret the x-ray, and had no need to consult the radiologist. He stated that from start to finish he read the x-rays, reduced the fracture, applied the cast, and made the follow-up examinations without any reference to or consultation with the radiologist or his report. The report was not made until the following day after the patient was long since gone. He testified that he probably received the report in due course, but did not know if he looked at it. He tried to read as many of them as he could. While these readings by a radiologist were referred to as “confirmative interpretation,” there is nothing in the record that they were ever consulted as such. In answer to the questions concerning the merits of such a rule requiring an interpretation by a radiologist of every x-ray, he stated “I enjoy the company.” He stated that a subsequent examination of Dr. Hammer’s report added nothing to his own knowledge.
This incident, while involving only $23.56, mirrors at least one cause of the burgeoning and rapacious cost of medical care. I would make no attempt to instruct the medical profession on what procedures are necessary, and what are not. However, here we are discussing a charge to a patient for a service not asked for by the treating surgeon, not used by the treating surgeon, or consulted by the treating surgeon, or anyone else. The form signed by Rumple authorized services deemed reasonable and necessary by the surgeon. He did not deem them necessary and did not use them.
It is my opinion that the person responsible for payment of the medical service, in absence of prior express approval, is not obligated under the omnibus consent form unless it is demonstrated that the service was in some way connected with the patient’s care, and contributed in some degree to the diagnosis or treatment, or the confirmation of the diagnosis or treatment, of the health problem of the patient which is finder investigation.
Here the interpretation and report was but an empty institutional ritual performed in obedience to a sweeping rule. Dr. Hammer’s report was buried, unread, in a file, where it reposed until disinterred by a billing clerk.