If You Think Your Doctor Is Scamming You Or Medicare,
Here's What To Do   

By Ron Smith
Seniorsadvocate.8m.com

What's that you say? Doctors make so much money there's no reason for them to get greedy and scam you or the insurance companies. Besides they adhere to a code of ethics, don't they? Well, think again.

A senior friend told me this story: "I'm diabetic and very much aware that going blind is a real threat for diabetics. I take an annual dilated eye exam and not once was there any sign of diabetic retinopathy (eye disease).

"I had been going to the same ophthalmologist for over ten years. Then he had a dispute with my insurance company, and it dropped coverage of his practice. I searched for a new ophthalmologist and found one who also owned and ran a laser eye clinic. After the first exam at the new clinic, I was shocked when the doctor told me I had diabetic retinopathy and would need laser surgery to correct the problem.

"But something didn't sit right about this doctor's diagnosis. Eye problems with diabetics tend to develop slowly. Since I had always received a clean bill of health, there was reason to question his conclusion. I decided to go back to my original ophthalmologist, have him examine my eyes, and pay the bill out of my own pocket.

"I did and was relieved to discover that my eyes were in good condition. Just to make sure, I asked a third ophthalmologist to examine my eyes. Same result: no diabetic retinopathy.

"I had to conclude that the laser eye clinic doctor was either incompetent or he was selling me a bill of goods. Since he also ran a laser eye clinic I concluded he was probably trying to scam me.

"Sure, Medicare and my supplemental insurance policy would have paid for the laser eye surgery. But seniors don't need any extra surgeries.

When You Question the Diagnosis
First, trust your instincts. Seniors have 60, 70, 80, or more years experience. So when that little voice inside you says something is amiss, listen to it. It could save you a lot of pain and money, even your life.

If you have any doubts, get a second opinion. And a third or fourth if need be. Even when that little voice inside you is quiet, if surgery is involved it pays to check further. Diagnoses can vary widely depending on the skill and experience of the doctor.

Third, if you suspect the doctor is deliberately recommending medical procedures you don't feel are necessary, contact your city, county or state consumer protection offices. For a complete listing of consumer protection offices go online to this Website: http://consumeraction.gov/caw_state_resources.shtm. You might also contact the local branch of the American Medical Association. And don't forget Medicare or your supplemental insurance company. They have staff who investigate fraud.

One caveat: your conclusion about malfeasance might be wrong. The incorrect diagnosis could be the result of something other than fraud. So, don't make accusations. Instead explain factually what happened and ask the consumer agency to conduct an investigation to get to the truth.

Ron Smith is a retired senior who lives in the Atlanta area. His book Scambusters: More Than 60 Ways Seniors Get Swindled and How They Can Prevent It was recently published by HarperCollins. He can be reached through his website at seniorsadvocate.8m.com.