I can provide you with numerous examples but perhaps I will share one common scenario that many doctors face:
Patient A comes into the clinic and he holds a medical benefits card belonging to a third party administrator, Company X.
He has a minor headache and requires some painkillers. However, as he is travelling soon, he would like medicines for his (potential) diarrhoea, vomiting, flu, cough, abdominal pain symptoms. He may also develop rashes when travelling so he will require some additional creams for his skin.
This causes his medical bill to increase from $25 to about $80, which is charged to Company X and to be reimbursed later to the clinic in 3 months' time. Company X is also okay to reimburse for travel medications but has not been paying promptly and appears to default on some payments, citing high costs and high medical bills.
This means that the doctor may not get his/her money back and may even lose money on the medicines. However the patient really needs the medicine as soon as possible, and he is leaving tomorrow night. If the doctor does not give him the medicines, he may lodge a complaint against him/her.
Should the doctor prescribe the medicines in such cases? Should the doctor worry about losing money? How should doctors deal with demands that put them in a difficult spot?
Managing expectations and open communication are important parts of being a medical doctor in any practice or speciality. In Singapore, we have the SMC Ethical Code and Ethical guidelines) to guide medical practitioners in delivering quality care to patients.