The powers that be have determined that doctors prescribe things that are not necessary. While I acknowledge that there are times when consumers — er, patients — are so taken with advertising that they insist on certain documentation from their doctors (cough*scooters*cough), by and large, most of the time I have very good reasons for prescribing the things I do.
One of the things falling under the heading of “Durable Medical Equipment” is prostheses of various kinds. I often get requests for a “Certificate of Medical Necessity” for these devices, with which I have no problem. There are times, though, when the questions become so nonsensical, I feel I have no choice but to spell it out for them:
This is a request for a CMN for a prosthesis for a partial foot amputation. (Click on the image for a larger view.) For anyone who can’t read my writing, what it says for Medical Necessity is this:
It’s not going to grow back.
Because it’s not.
Musings of a Dinosaur 
It’s a bit of a standing joke here in Israel — or I thought it was — that our National Insurance Institute [Bituach Leumi] requires amputees to submit to an annual examination for renewal of their handicapped status and continuance of the benefits they get for being handicapped.
I wrote above that I thought it was a joke, until I received a letter telling me that they had to check to see whether I still had a total hip replacement or not.
By: Antigonos on December 21, 2012
at 10:49 am
[…] Another great example: Medical Necessity « Musings of a Dinosaur. […]
By: Saving Primary Care? It’s Not All About Money. « Woman, Food, & Shiny Objects on December 23, 2012
at 2:59 pm
Best. Doctor.Ever. So pragmatic she reveals our asinine health system to be what it is…..IMHO…….Susan
By: Susan Flavin on January 11, 2013
at 8:42 am