医院革命

New Amsterdam S01E08

Part 5 Nov. 27, 2019, 1:17 p.m.

-不他们这根本是歧视 -你得理解
- No, it's about stigma. - You have to understand
他们就是太在意他人的想法
that they are afraid of what others think.
为什么要在意别人想法
Yeah, well, who cares what others think?
我们都想要给她提供最好的解决方案
Look, we all want what's best for her, okay?
但我们没法一夜之间改变文化排斥
But we can't fight every cultural stigma in one day.
-跟你说了这是排斥 -这是羞耻
- Told you it was stigma. - It's shame.
她是我们想帮助得到病人
We've got a patient that we want to help,
但是我们不能帮她
but we can't help her
就因为这些愚蠢的医疗保险表
because of all these stupid insurance forms.
-你说得对 -听到了
- You're right. - See?
关于哪部分
About what?
-开低价账单 -你认真的吗
- Downcode it. - Are you serious?
我不得不这么做
I had to do it for girls
为了那些父母不允许她们避孕的女孩们
whose parents wouldn't allow them birth control.
以「圆形韧带疼痛」的理由开账单
Billed it as "Round ligament pain."
我们会被看做没能力的
We would look incompetent.
但这样能帮到病人
But you'll help the patient.
你想让我们欺骗医院
You want us to defraud the hospital?
没错
Exactly.
好吧
Okay...
麦克斯
Max.
你到底跟拉比说什么了
What the hell did you tell the rabbi?
我不知道你在说什么
I have no idea what you're talking about.
在你跟他谈完之后他改变了主意
After you talked to him, he changed his mind.
你说服了他进行有风险的手术
You have just talked him into a risky surgery
他有可能死在手术台上
that will most likely lead to his death.
抱歉简让我们单独聊一下
Sorry, Jane? Give us a second.
拜托了
Please?
你一定在奇怪我为什么改变了主意
You're wondering why I changed my mind.
我在祈祷不是因为我
I am praying it is not because of me.
怎么说呢你说得很有道理
What can I say? You made a good case.
这是高风险手术
This is a high-risk surgery.
对我来说以我个人的观念影响病人
And for me to tip the scales in any way with my own baggage
正是不道德的行为
is the definition of unethical.
那真不巧
Tough luck.
你有
You did.
-麦克斯 -拉比
- Max. - Rabbi.
麦克斯我是自己下的决定
Max, I make my own decisions.
没错我可以回家跟家人一起
Yeah, I could be home with family.
但我仍是个病人
But I'd still be a patient.
这不是我想要的生活
That's not the life I want.
如果我做手术
If I do this,
明天我要么变得更好要么死去
tomorrow I'll be better or I'll be dead,
但是我不再是个病人
but I won't be a patient.
不确定你这番话是否能让我免于医疗事故诉讼
Not sure that clears me of the malpractice suit, but...
麦克斯大胆做吧我豁免你
Max, go. I absolve you.
错误的信仰
Wrong religion.
现在你就是在找茬了
Oh, now you're being picky.
抱歉拉比
Sorry. Rabbi?
亚伯拉罕真的牺牲了自己的儿子吗
Did Abraham actually sacrifice his own son?
没有
No.
一个天使下凡阻止了他
An angel came down and stopped him.
他的确打算这么做
But he was going to.
而这已经足够通过神的考验了
And it was enough to pass God's test.
所以神奖励他
And God rewarded him with as many children
让他拥有和星辰砂砾一般多的子女
as there are stars in the sky and sands in the sea:
就是犹太族人
the Jewish people.
有些事值得冒险
Some things are worth the risk.
为什么细胞分选仪在走廊里
Why is there a cell sorter in the hallway?
它连不上其他的机器
It won't connect to the other machines.
官僚制度
Bureaucracy.
让医疗联盟把它收回去
Tell HCC to take it back.
他们不会的
They won't.
简直像我们在军队工作一样
It's like we're working for the army.
那这个也不能放这
Well, it can't live here.
我知道你能把它带走吗
I know. Can you take it?
然后拿它干什么
And do what with it?
不知道但今天是我生日
I don't know. But it's my birthday.
医生我是来自计财处的桑德拉·福尔
Dr. Goodwin, Sandra Fall from billing.
哦你给我留言了对吧
Yes. You left me a message?
是的你没有回我的电♥话♥
Yeah, and you didn't call me back.
我就觉得我今天有件事情忘了做
I knew there was something I forgot to do today.
你知道你手下有两名医生在开低价账单吗
Um, are you aware that two of your doctors are downcoding?
开低价账单
Downcoding?
是的就是医生开出低价账单
Yeah, it's when doctors bill for something small
同时却提供昂贵的医疗服务
but provide more expensive care.
他们为什么要这么做
Why would they do that?
因为如果他们高报医药费
Because if they were upcoding,
他们能通过这种方式赚钱但开低价账单
they could make money, but downcoding--
是的没错
Yeah, exactly.
所以他们让我记下当前诊治专用码90868
So they told me to put down CPT code 90868
是用于蒋艾米的经颅直流电刺♥激♥
for transcranial electrical stimulation for patient Amy Chiang,
但是账单上并没有包括
but that doesn't require three weekly sessions
精神病区的一周三次疗程所以我会通知
in the psych ward, so I will also notify--
好的我认栽是我让他们这么做的
Okay, you got me. I told them to do it.
我只是希望他们能手段高明点
I just hoped they would do it a little better.
你让你手下的医生
Uh, wait, you told your doctors
敲诈医院的资金
to extort money from the hospital?
你这样的说法真的听起来很糟糕
Well, it sounds really bad when you say it like that,
但
but, uh,
我们只是试图帮助一个病人
we were just trying to help a patient.
但是我的工作是
Yeah, and it's my job
确保医院有足够的资金
to make sure the hospital has enough money
能帮助所有病人
to help all our patients.
到底是什么时候才有人把这个东西搬走
When is somebody gonna get this thing out of here?
你问得很好
You bring up an excellent point.
所以你打算怎么补偿医院损失的收益
So how do you intend to make up the lost revenue?
十万美元足够了吗
Would $100,000 cover it?
你能这么做吗
You can do that?
虚假治疗名目
Call therapy something else?
我们只是想通过一切办法帮助你
We want to get you the help that you need any way we can,
所以我们会在这里进行治疗
so we're gonna start therapy in here,
等你恢复得好些了就一周三次
while you're in recovery, three times a week.
而且我会根据你们学校的课程时间进行调整
And, uh, and I will navigate your school schedule
还有你的工作时间
and your work schedule.
你妈妈绝对不会发现的
Your mother will never find out.
但那是在撒谎
But it's a lie.
从纸面上看是的
On paper, yes.
那我该说些什么呢
And what will I tell my mother
当她问起我的脑部刺♥激♥
when she asks about the brain stimulation?
你可以告诉她那非常有促进作用
Well, you can tell her it was very stimulating.
那我就是在对她撒谎了
So then I will be lying to my mother.
还有我的父亲
And to my father.
-这是为你的心理健康着想 -她会知道的
- It's for your mental health. - She'll know.
就算她什么也不说
And even if she doesn't say anything...
她也会评判我
she'll judge me.
我能教你一些应对机制
I can teach you some coping mechanisms.
她不会像以前一样爱我了
She won't...love me the same.
有针对这种情况的应对机制吗
Is there a coping mechanism for that?
报低价账单会有效
The downcoding will work.
但从长远角度看对她没有帮助
But it's not gonna help, not in the long run.
不得不对她的家人撒谎的压力
The stress of having to lie to her family
只会加剧她的忧郁
is only going to exacerbate her depression--
还有孤立感
her sense of isolation.
我们唯一的选择就是说服她的母亲
Our only option is to work around the mother.
这就是问题所在
I think that's the problem.
我不认为我们要说服她的母亲
I don't think we should work around her.
我们应该让她的母亲参与进来
I think we should bring her in.
-参与进治疗 -是的
- For therapy? - Yeah.
他们需要一起参与治疗过程
They need to do it together.