What Are A Patient's Rights When Doctor Orders Unauthorized Tests?

Patient (with no medical insurance) went to see doctor to obtain a refill Rx on thyroid medication. Doctor insists on lab work prior to issuing refills. Patient agrees under the assumption that only the basic CBC and TSH were order.

Patient now receives a $700.00 bill for lab work (10 tests ordered)鈥攓uite extreme for issuing a refill Rx. Since this was not disclosed ahead of time, nor was the associated cost鈥攚hat are the patient鈥檚 rights?

The patient is NOT new...and in the past just a CBC and TSH were performed to check levels prior to refill. Non-insured status was stressed upfront to doctor and basic tests ONLY were authorized by patient in email to doctor because non-insured status. Doctor did not discuss the test requested or the cost with patient at any time.

1) Talk to doc and find out exactly what tests were ordered, and confirm that the additional tests weren't dones as a lab error.

2) Contact American Medical Society (or a similar healthcare association) to find out what standard tests should be ordered for your condition. Maybe you have copies of past lab test results that you can compare to the most recent ones to see if there are more tests in one than the other.

3) If what the doc order wasn't standard or reasonable, ask the AMA for advice on you rights under the circumstances.

Rather than anyone paying the extra costs, maybe your doc can negotiate with the lab to reduce what you owe. Since the lab gets business from the doc, they might be agreeable. If not, maybe you can negotiate with the doc to credit your account with her office for an amount equal to the additional lab fees that were incurred.

Well with thyroid issues it is a tough call. It is a very tricky gland that experiences extreme changes at times depending on your diagnosis. To refill an Rx on thyroid hormones without doing necessary tests could cause more of a problem for the doctor because it could put you at more risk of developing a worse condition. It is your right to ask questions regarding the procedures and costs associated while you are in their care. Your right is to deny treatment at anytime you feel like you dont want a procedure. I am a student in Nuclear Medicine and know a little about thyroid issues and their complexity. This sounds like he did the right thing that was in his scope of practice. However you have the right to contest, and see the bill and all of the prices associated and get a second opinion. Of course there is always some leeway given where they wont charge you if they did not explain the procedure to you properly. Did you tell them you were without insurance? Usually they will warn you about how big of an expense it will be for you. If not call them now and tell them that you got the bil and you are without any insurance and cannot by any means pay that amount, see what they can do for you. Usually this is passed through many hands and the biller might not have known about your lack of finances.

Under the assumption??? Whose assumption? If you are a new patient the doc needs to do a full and complete assessment to protect him/herself from charges of negligence. This whole thing should have been discussed with the physician ahead of time and NOT assumed to be "basic" only, whatever that means. The doc may have had his/her own very good reasons for doing these so-called unauthorized tests. Sorry, but if you've singed in writing an agreement to be financially responsible for charges as a self-pay patient, you may have no recourse here. But you have learned a lesson, haven't you?

it would be completely unethical for a physician to prescribe thyroid medicine to you without up to date labs. this is due to the fact that you could have changes in your tsh and freet4 t3 way before any physicals symptoms are noticed. if i have established patients who are dong well , i amy let them go up to 4-6 months without updatec labs but a new patient would be mandatory to have a baseline. end of discussion

doctors don't normally know anything about the specific costs of the tests. since it seems you have been to the doctor multiple times and only a CBC and TSH were ordered - the doctor probably figured it was time to order additional tests.

i think you may be out of luck - sorry