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Years ago I had a patient who needed laparoscopic surgery. She also had a platelet disorder that could cause excessive bleeding. Because her surgery was an "outpatient" procedure, her HMO insisted that I do her case in a less expensive surgicenter. I wrote a letter of appeal, citing the patients risk factors and the increased safety of the hospitals operating room. Appeal denied.
The patient could not afford to pay for the hospital costs herself, and I refused to operate on her in a surgicenter. Her primary care physician referred her to a different surgeon who was willing to comply with the HMOs requirement. She had a bleeding complication. She was transferred to the hospital by ambulance where she died.
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My work here is nearly finished.
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