Why Do They Call it Peer-to-Peer Review?


Just got off the phone with a sell out.  You see, I ordered at CT of the abdomen on a patient and someone else rejected that order. I will not go into detail in this blog other than to say that the “doctor” I spoke to got into a fight with me.  Sure I was terse with her as well but she told me that I needed a abdominal and pelvic ultrasound first. So, the conversation went as follows:

Me: “What if the ultrasound doesn’t show anything?

Insurance doctor: “Then you can order the CT”.

Me: “What if the ultrasound shows an abnormality?”

Insurance doctor: “Then you can order a CT to confirm it”?

Does anyone see the insanity of this?  I sure hope so.  Let’s just say the conversation ended with raised voices and me hanging up.  Prior to leaving the conversation there were some heated words. No curses but I may have mentioned “selling your soul”.  Anyway, she used the phrase “Doctor, you are being abusive”.  Abusive?  Because I am fighting for my patient?  Because the system is ludicrous? Because the patient was relying on me to get this done?  Because I, and not the insurance company, is liable if the CT gets delayed and not done?  Because this supposed doctor does whatever the insurance company tells her to do?

This is a warning to you doctors out there.  My guess is that the “Doctor, you are being abusive” line was taught to her and is a common phrase used to defend themselves .  It is verbal judo to turn the table on you and show that they are now the victims.  Do you see how pathetically brilliant this is?

90960cookie-checkWhy Do They Call it Peer-to-Peer Review?