Scum of the Earth
and no it's not lawyers...

It's doctors who work for insurance companies.
This week was very busy for me. I was "on service" which means that I round with the residents in the hospital all day and answer pages all night. One of my patients this week was a young man whose condition required very intensive inpatient therapy. Ideally it would be at some sort of rehab facility. I got a call from his insurance company on Tuesday saying that they were not going to pay for any more of his hospitalization. In fact they weren't going to pay for the last week either. When I called, the nice lady who answers the phone for them suggested I have a "peer to peer" review of the case. Sounded good to me so I agreed and a little while later the devil himself called me back.
"This is Dr. -------" he said, "I understand you want our decision (Code for we're not paying) reviewed."
So after a long discussion about how this child would not last 24 hours at home, how I feared for his life and well being and how he was much sicker than his numbers looked Dr. Devil told me he wasn't changing his mind. I asked him what I should do for this child. He suggested an inpatient rehab facility. I informed him his boss wasn't paying for that either. After a moment of silence he directed me to an appeals process in not very nice terms. He then told me that my patient and his family would just have to "cope".
That is where things could have really broken down. I wanted to:
1. Ask him how many people you have to kill on the operating table before they take away your licence and you have to work for the insurance company.
2. Ask him if his mother would be proud of what he did every day and if this was the reason he went to medical school. And where the Hell did he go to medical school anyway?
3. Wish this nasty disease on his children so that his employer could deny him of benefits.

But I didn't. I just told him I thought this was rediculous and hung up on him.

Stupid insurance doctors.