A gastroenterologist opines on the increasing regulations that we all have to endure:
This can be quite absurd. I am a board-certified gastroenterologist. I used to be able to check patients in the hospital for occult bleeding with a simple rectal exam, putting a small stool sample on a test card and developing it at the bedside, looking for a color change. This is important information, easily obtainable. But no longer by me, because, under a recent new rule, gastroenterologists are no longer certified to judge the color difference. Does this make sense? Of course not. Can I change it? Apparently not, in part because making a common-sense argument is getting to be as strange as a $3 bill. Even smart, well-meaning people will kowtow to these rules rather than fight them with common sense.
(via gus van horn)
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{ 8 comments }
Clearly, what we need is a much, much larger role for government in health care.
Or something.
Ayn Rand fabulously illustrated scenarios like this in Atlas Shrugged. And that was written half a century ago.
xIt’s hit all areas. The century old standard of measuring hematocrit by centrifuging a capillary tube has now been judged unacceptable because we would need to run standard samples every shift and undergo periodic retraining. So this has meant on two occasions for me (12 for our group) the placement of central lines in kids impossible to draw blood from just to obtain the simplest and oldest of blood exams. Uncounted hematocrits have never been checked because no sample could be had and central access was too outlandish.
Now I know I’m in good company.
NICU nurses haven’t been “competent” to check stool samples for occult blood in quite sometime. Not only that, but we can’t even dip urine or check the specific gravity on a refractometer – a fairly idiot-proof piece of equipment.
We can check hemoglobin levels, because the gadget we use for that hasn’t been removed from the unit yet. I think they forgot.
I’m going to retire if they decide we can’t do point of care blood sugars. Waiting 30-60 minutes for an answer from the lab could be lethal.
What if we all just decided to start ignoring the CLIA rules one day–July 4 would be a good day.
I worked in labs as an undergraduate and summers during medical school. I’ve done CBC’s on automated equipment, and with manually hemocytomters, spun and streaked thousands of urines and throat swabs, have a degree in biochemistry, and some government dweeb tries to tell me I can’t do a stool guaic?
I still keep it in my pocket for my diagnostic purposes. Screw the lab and administrative wonks.
Of course, as a hospitalist it’s convenient. I can order it and deer the rectal if it’s positve to the next shift.
Ah, isn’t medicine great to nurture these deliquent behaviors.
All the hospitals I have been at in recent years took away stool cards. They claimed patients were getting them done without being billed. Now we wait 2-3 days for a poop, then send it to the lab where it takes 2 days to get a result. Awesome.
Also the RNs cannot place PPDs anymore. They must be placed and read by an MD.
Anon 8:27 shows why there is still a need for UM people to refuse to pay for wasted hospital days
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