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How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?

On December 23, 2013 I finally got an appointment with a dermatologist in Geneva. This doctor does not have office hours everyday in the clinic, so it seems hard to get hold of somebody by phone to make an appointment. Previously when I called to schedule an appointment, the secretary forgot to record the appointment in the computer, so I drove to the office in vain. That was when they gave me the appointment on Dec. 23, 2013. I wanted a brief consultation.


A few years ago when I watered my plants, a tiny cactus needle got into my right thumb. I used a needle with my left hand trying to take the needle out, but failed. The wound healed. But sometimes it hurts. Sometimes the area became a little swollen. To my surprise, the doctor said he could do a surgery right away to remove the needle. I am the kind of person who always find it so hard to say "no". So I just listened to his words. But later on, when he was preparing for the procedure, he said since the needle was small, it might not be possible to take it out. I was thinking, then why did he want to do a surgery then?! He used a big needle ti inject anesthesia - it was very painful. Then he used a knife to take out a piece of flesh from my right thumb. He sent that piece to the lab at Cantonal  Hospital. The Hospital lab did not find any needle in the piece of flesh.


I heard that in Switzerland or Geneva, any time when anesthesia is applied, the doctor could give the patient a certificate to rest from work. I told the doctor that work with computer, using my hand a lot, he did not give me a certificate to rest from work. He said, "you can work, you can type. No problem". He did not prescribe any pain medicine, either. In the evening, when the anesthesia wore out, the surgery area was so painful that I could not sleep. I went to the pharmacie as soon as I could to buy pain killer. For the next few days, I had to hold my hand up to help reduce pain. I could not type, I could not cook, I could not wash..... the thumb got so swollen -  it got infected. I was put on 7 days of antibiotic. I had told the doctor that I had been taking medicine for a chronic disease, and I can easily get infection. Obviously this doctor totally forgot about that. After the antibiotic, the thumb was still swollen and painful.


I wrote to the dermotologist to complain and cancelled the follow-up appointment with him.  Eventually I went to an emergency clinic, with a few more bills for blood test, x-ray......


I received a bill for SF341.10 from the dermotologist. I asked my insurance if I could refuse to pay the bill. My insurance is not a local Swiss insurance company, and their policy is that this kind of matter is between the patient and the doctor. I heard that Swiss insurance companies will do something about unsatisfactory medical practices. I do not have any ideas about the real situation in Switzerland regarding this kind of problem. I was even thinking maybe I should consult a lawyer. The doctor wrote back and said he was sorry that I did not go back to him for the follow-up appointment. I feel that this surgery was not necessary. It was poorly done. The doctor was not sensitive to patient's condition and needs. Should I hold the doctor responsible? Or should I pay the bill and forget about this problem?


Do as the Romans do - what would a local Swiss person do? Thank you for any advice you could offer! Best wishes!

The text you are quoting:

On December 23, 2013 I finally got an appointment with a dermatologist in Geneva. This doctor does not have office hours everyday in the clinic, so it seems hard to get hold of somebody by phone to make an appointment. Previously when I called to schedule an appointment, the secretary forgot to record the appointment in the computer, so I drove to the office in vain. That was when they gave me the appointment on Dec. 23, 2013. I wanted a brief consultation.


A few years ago when I watered my plants, a tiny cactus needle got into my right thumb. I used a needle with my left hand trying to take the needle out, but failed. The wound healed. But sometimes it hurts. Sometimes the area became a little swollen. To my surprise, the doctor said he could do a surgery right away to remove the needle. I am the kind of person who always find it so hard to say "no". So I just listened to his words. But later on, when he was preparing for the procedure, he said since the needle was small, it might not be possible to take it out. I was thinking, then why did he want to do a surgery then?! He used a big needle ti inject anesthesia - it was very painful. Then he used a knife to take out a piece of flesh from my right thumb. He sent that piece to the lab at Cantonal  Hospital. The Hospital lab did not find any needle in the piece of flesh.


I heard that in Switzerland or Geneva, any time when anesthesia is applied, the doctor could give the patient a certificate to rest from work. I told the doctor that work with computer, using my hand a lot, he did not give me a certificate to rest from work. He said, "you can work, you can type. No problem". He did not prescribe any pain medicine, either. In the evening, when the anesthesia wore out, the surgery area was so painful that I could not sleep. I went to the pharmacie as soon as I could to buy pain killer. For the next few days, I had to hold my hand up to help reduce pain. I could not type, I could not cook, I could not wash..... the thumb got so swollen -  it got infected. I was put on 7 days of antibiotic. I had told the doctor that I had been taking medicine for a chronic disease, and I can easily get infection. Obviously this doctor totally forgot about that. After the antibiotic, the thumb was still swollen and painful.


I wrote to the dermotologist to complain and cancelled the follow-up appointment with him.  Eventually I went to an emergency clinic, with a few more bills for blood test, x-ray......


I received a bill for SF341.10 from the dermotologist. I asked my insurance if I could refuse to pay the bill. My insurance is not a local Swiss insurance company, and their policy is that this kind of matter is between the patient and the doctor. I heard that Swiss insurance companies will do something about unsatisfactory medical practices. I do not have any ideas about the real situation in Switzerland regarding this kind of problem. I was even thinking maybe I should consult a lawyer. The doctor wrote back and said he was sorry that I did not go back to him for the follow-up appointment. I feel that this surgery was not necessary. It was poorly done. The doctor was not sensitive to patient's condition and needs. Should I hold the doctor responsible? Or should I pay the bill and forget about this problem?


Do as the Romans do - what would a local Swiss person do? Thank you for any advice you could offer! Best wishes!


Jen CMar 19, 2014 @ 21:57
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 1

If you have legal insurance, ask their advice. If you don't, pay and move on cos fighting this will take too much time /energy / money.


 

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If you have legal insurance, ask their advice. If you don't, pay and move on cos fighting this will take too much time /energy / money.


 


Nir Ofek, Mar 19, 2014 @ 23:31
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 2

Hi Jen, 


It sucks, your situation, but I would agree with Nir. 


I have not had many experiences with docs in GVA, but my good lady has. And no offence to any docs on here, but there is a fair amount of crooks. Thankfully my Mrs parents were docs so she is quiet clinical and abrupt with docs and the health system in general. 


My advice is to pay up, and take it as a lesson. Work on saying 'No' and walking out and getting a second opinion. These docs are used to it, swiss and expats around here make enough money, and pay enough to insurance companies to be snoby about it. The doc wont be upset, trust me. My lady trialed 5 different gynecologists at the beginning until she found a nice one that she trusts. I wont even begin on her dermotologist shopping. 


In regards to taking the doc on legally, that would be a tough one, particularly of your insurance company is not behind you, docs are well protected by their insurance companies. 


PM me if you want me to find out Mrs M's doctor details, and can pass them on happily. 


 

The text you are quoting:

Hi Jen, 


It sucks, your situation, but I would agree with Nir. 


I have not had many experiences with docs in GVA, but my good lady has. And no offence to any docs on here, but there is a fair amount of crooks. Thankfully my Mrs parents were docs so she is quiet clinical and abrupt with docs and the health system in general. 


My advice is to pay up, and take it as a lesson. Work on saying 'No' and walking out and getting a second opinion. These docs are used to it, swiss and expats around here make enough money, and pay enough to insurance companies to be snoby about it. The doc wont be upset, trust me. My lady trialed 5 different gynecologists at the beginning until she found a nice one that she trusts. I wont even begin on her dermotologist shopping. 


In regards to taking the doc on legally, that would be a tough one, particularly of your insurance company is not behind you, docs are well protected by their insurance companies. 


PM me if you want me to find out Mrs M's doctor details, and can pass them on happily. 


 


Kevin M, Mar 20, 2014 @ 01:17
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 3

It happened to me once, I just wrote and explained why I was unhappy and why I refused to pay. It worked.

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It happened to me once, I just wrote and explained why I was unhappy and why I refused to pay. It worked.


hay_, Mar 20, 2014 @ 15:31
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 4

If your French is good enough and you want to fight, check this out:


 


http://www.permanence-info-mediation.ch/index.php?option=com_content&view=article&id=47&Itemid=57


 


Good luck!

The text you are quoting:

If your French is good enough and you want to fight, check this out:


 


http://www.permanence-info-mediation.ch/index.php?option=com_content&view=article&id=47&Itemid=57


 


Good luck!


hay_, Mar 20, 2014 @ 21:13
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 5

As per the comments above, you´ll have to see if you think it is worth looking further into a legal route for this.


A few links that might help to get more information and could be useful in future:


http://www.sso.ch/index.cfm?uuid=1AAD592CD9D9424C43527E423C4E5B28&cmd=&o_lang_id=8 (Society of Dentists, has a section for patients on their website)


http://onb.tarmedsuisse.ch/tarmedbrowser/tarif.do? (established tariffs for medical procedures and visits)


http://www.federationdespatients.ch/ (patients federation)


http://www.amge.ch/medecins/annuaire-des-medecins/ (listing of doctors in Geneva. It indicates whether they belong to a Medical Association, etc).


Despite what Swiss people will argue, their medical system is far from perfect and I´ve had my share of not so great service.  Some basic rules to apply to help you as a patient: ask for a quotation before a large procedure or surgery and check with other doctors too - they are used to this and it will not be held against you.  Before new special tests are done, ask how much they cost. Luckily I did this before a cardiologist was about to do a fairly "optional" test that was used for professional divers just because I was going on a diving holiday - it saved me CHF 1,000.


This is not exactly your case, but in three years I have contested three bills: one for a dentist X-ray study that never happened, and one at the HUG for a scan that was set up but actually never happened (and the doctor said that same day that the equipment had been prepared by error), and one that added a check up on a Saturday which I definitely did not attend. Check your bills carefully and remember what you had done (one of the bills was sent over a year after the visit!). Send firm letters, pointing out what you did, what charges you agree with and which ones you will not pay, and remind them that your medical records will prove that you did not have all that done. Send reminder letters if you do not hear back and give a deadline by when you want it sorted and a new adjusted bill or written confirmation that the bill has been voided. (All by registered post, should you ever need evidence of delivery).  Eventually it gets sorted out.


I have a high franchise so I have to pay for most things myself until the insurance kicks in.  The advantage of being in a system that is so expensive is that it entitles you to a more "paying customer" approach: you are paying for a service and you have the right to see, compare and choose, and receive exactly what you paid for. This includes doctors that make you feel at ease, take the time needed and explain everything, otherwise you move to the next on the list.


 


 


 


 

The text you are quoting:

As per the comments above, you´ll have to see if you think it is worth looking further into a legal route for this.


A few links that might help to get more information and could be useful in future:


http://www.sso.ch/index.cfm?uuid=1AAD592CD9D9424C43527E423C4E5B28&cmd=&o_lang_id=8 (Society of Dentists, has a section for patients on their website)


http://onb.tarmedsuisse.ch/tarmedbrowser/tarif.do? (established tariffs for medical procedures and visits)


http://www.federationdespatients.ch/ (patients federation)


http://www.amge.ch/medecins/annuaire-des-medecins/ (listing of doctors in Geneva. It indicates whether they belong to a Medical Association, etc).


Despite what Swiss people will argue, their medical system is far from perfect and I´ve had my share of not so great service.  Some basic rules to apply to help you as a patient: ask for a quotation before a large procedure or surgery and check with other doctors too - they are used to this and it will not be held against you.  Before new special tests are done, ask how much they cost. Luckily I did this before a cardiologist was about to do a fairly "optional" test that was used for professional divers just because I was going on a diving holiday - it saved me CHF 1,000.


This is not exactly your case, but in three years I have contested three bills: one for a dentist X-ray study that never happened, and one at the HUG for a scan that was set up but actually never happened (and the doctor said that same day that the equipment had been prepared by error), and one that added a check up on a Saturday which I definitely did not attend. Check your bills carefully and remember what you had done (one of the bills was sent over a year after the visit!). Send firm letters, pointing out what you did, what charges you agree with and which ones you will not pay, and remind them that your medical records will prove that you did not have all that done. Send reminder letters if you do not hear back and give a deadline by when you want it sorted and a new adjusted bill or written confirmation that the bill has been voided. (All by registered post, should you ever need evidence of delivery).  Eventually it gets sorted out.


I have a high franchise so I have to pay for most things myself until the insurance kicks in.  The advantage of being in a system that is so expensive is that it entitles you to a more "paying customer" approach: you are paying for a service and you have the right to see, compare and choose, and receive exactly what you paid for. This includes doctors that make you feel at ease, take the time needed and explain everything, otherwise you move to the next on the list.


 


 


 


 


J. F, Mar 22, 2014 @ 18:33
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Re: How to Handle Medical Bill from an Unsatisfactory Doctor Visit/Unnecessary Medical Procedure in Geneva?
Post 6

Thank you all who have taken the time to write and offer me valuable advice! I had a medical condition unexpectedly, so I apologize for not responding sooner. I was fine in the morning and majority time of a coffee break with a colleague on Thursday, till our conversation started to touch some of the work-related problems. All of a sudden, I had severe pain in my stomache area that I had to rush to the medical clinic. I thought I was suffering from internal bleeding. My blood pressure went up to 200! The doctor thought I had gallstone, kidney stone..... almost called an ambulance. Eventually she concluded that it was stress that caused the pain. So I know I am not good at dealing with stress. I was so upset after the thumb surgery that I totally forgot that I have TCS legal insurance! I used this insurance a few years ago and wrote a commendation letter to thank the young lawyer who went out of his way to help me. But his boss said after receiving my letter that I used the insurance too much and it was not fair to other clients..... I was quite hurt when hearing this comment, so I did not even think that I could ask for advice. 


The wound has finally healed. But the surgery area has a hard lump. I had used an external medical cream to help the area heal. Definitely it is worse than before the surgery.


It is not the money issue. I have bought a supplementary insurance out of my own pocket, so my medical bills are covered almost 100%. It is the way I was treated, or why I was treated. It makes me upset. But I know I am not a fighter. Thanks to everybody here!

The text you are quoting:

Thank you all who have taken the time to write and offer me valuable advice! I had a medical condition unexpectedly, so I apologize for not responding sooner. I was fine in the morning and majority time of a coffee break with a colleague on Thursday, till our conversation started to touch some of the work-related problems. All of a sudden, I had severe pain in my stomache area that I had to rush to the medical clinic. I thought I was suffering from internal bleeding. My blood pressure went up to 200! The doctor thought I had gallstone, kidney stone..... almost called an ambulance. Eventually she concluded that it was stress that caused the pain. So I know I am not good at dealing with stress. I was so upset after the thumb surgery that I totally forgot that I have TCS legal insurance! I used this insurance a few years ago and wrote a commendation letter to thank the young lawyer who went out of his way to help me. But his boss said after receiving my letter that I used the insurance too much and it was not fair to other clients..... I was quite hurt when hearing this comment, so I did not even think that I could ask for advice. 


The wound has finally healed. But the surgery area has a hard lump. I had used an external medical cream to help the area heal. Definitely it is worse than before the surgery.


It is not the money issue. I have bought a supplementary insurance out of my own pocket, so my medical bills are covered almost 100%. It is the way I was treated, or why I was treated. It makes me upset. But I know I am not a fighter. Thanks to everybody here!


Jen C, Mar 22, 2014 @ 19:42
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