Saturday, September 13, 2014

Doctors’ Chief Complaint: Too Little Time with Patients

Endlessly entering data or calling for permission for prescribing or trying to avoid Medicare penalties – when should I see patients?

Mark Sklar, MD, solo endocrinologist and assistant professor of medicine at Georgetown University Medical Center and at George Washington University Medical Center, “Doctoring in the Age of ObamaCare,” Wall Street Journal, September 11, 2014

Every doctor knows a physical examination begins with the chief complain- why the patient has come to see you – followed by the history – the patient’s story with their list of symptoms.

Doctors’ chief complaint is too little time for patients because of because of the bloated incomprehensible in comprehensible federal health regulations.

Patients feel this lack of face-to-face time with doctors as well. Some say nurse practitioners and physician assistants and virtual e-mail or video communication can replace face-to-face visits and relationships, but doctors and patients are skeptical.

The doctors’ chief complaint and story goes back to March 23, 2010 when ObamaCare passed in a straight party-line vote against public opposition, which remains to this day in both the doctor and patient sectors.

The doctors’ complaint centers on these symptoms: 25% more time spent on paperwork, data entry, and third party hassles than with patients.

Add to this money needed to be spent to set up an electronic health system. These system often incompatible and cannot communicate with EHRs of hospitals and other doctors. More money and time goes into training new staff to enter data and maintain EHRs, anticipating and prepared interpret the 70,000 new ICD-10 codes which will have to entered correctly into EHRs at the risk of severe Medicare penalties, and you have ingredients of formula for physician burnout and disillusionment, retirement, hospital employment, refusal to see more Medicare and Medicaid patients, retirement, and a switch to direct pay independent practices unchained from third party insurance and involvement with unlimited time devoted to patients.

Maybe doctors doth protest too much. Maybe doctors should just set their chief complaint aside , accept the inevitable, and place their trust in a well-intentioned , compassionate government.

Maybe they should heed the words of the late Doctor Harvey Cushing (1869-1939):

“Things cannot always go your way. Learn to accept in silence the minor aggravations, cultivate the gift of taciturnity, and consume your own smoke with an extra draught of hard work, so that those about you may not be annoyed with the dust and soot of your complaints .”

In short, stop blowing smoke and suck it up.

But maybe when these “minor aggravations” become major impediments and take time away from patients, doctors should speak out and strike out on their own to serve patients directly without government interference and intervention.

No comments: