1) The Progressive Pulse: “[NC gubernatorial candidate] Pat McCrory seems more obsessed with ‘tort reform’ ““ lowering malpractice insurance costs for doctors ““ than with health reform ““ lowering health insurance premiums for everyone.”
My take: Tort reform begets health reform. If the fear of baseless liability is removed, physicians will be less apt to order defensive tests or reflexively advise patients to go to the emergency room. In a perfect world, costs will be driven down leading to lower premiums for everyone.
2) Red Sox pitcher Curt Schilling attributes the debacle surrounding the diagnosis of his shoulder to “medical egos“.
My take: This is demonstrative of medicine’s inherent uncertainly. In many cases, there are significant gray areas with multiple treatment approaches. That’s why doctors have differing opinions. Patients want black and white, and that isn’t possible.
Physician egos are not to blame for the confusion surrounding Schilling’s diagnosis. There are several ways to fix a shoulder skin a cat, and no where is that more true than in medicine. Schilling needs to come to grips with that and stop blaming his doctors.
3) Well: “Providing a surgeon’s e-mail address nearly triples the likelihood that a patient will contact the doctor about the surgery.”
My take: That’s a no-brainer. Many patients prefer to communicate with their doctors via e-mail. Believe it or not, physicians would be just as enthusiastic to return the favor. E-mail cuts down on phone calls, and a sizable number of complaints can be handled over the internet.
It comes as no surprise that common sense is impeded by hurdles. HIPAA forbids physician-patient communication over standard e-mail because it is not encrypted. Cumbersome third-party applications have to be used for the physician to legally respond over e-mail.
E-mails are also rarely reimbursed by insurance companies, giving physicians no financial incentive to pursue this route.
If patients truly want expanded physician e-mail use, the government and insurance companies need to be lobbied to remove these obstacles.
Related posts:
- Universal care, increasing patient safety, and tort reform, all in one fell swoop?
- Another tort reform success story
- Tort reform in Oklahoma
- Thanks, tort reform
- How tort reform can stimulate the economy
- Doctor will not treat Oklahoma tort reform dissenters
- Texas tort reform
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What disturbs me more is a reply Tara Parker Pope (the Times Health columnist) leaves in a comment halfway down the page, on 2/18 at 8:35 pm [excerpted]:
From TPP — I find your response interesting in light of the earlier comment about the terrible liability doctors take on when they email patients. Personally, I think that’s a copout, but i wonder if that is an issue you have considered or worried about.
She doesn’t understand or point out in the article that it’s not liability they’re worried about, but HIPAA. Several other people take great pains to point that out further down the page, but honestly, her comment replies always feel half off the mark like that. I’m not very impressed. Some of the woo-ish positions she’s staked out are a bit annoying: my uncle sends out emails about unproven herbal medicines or iridology but he doesn’t get taken as seriously as someone writing in the Times Health section.
I would not worry about emails’ not being reimbursed when phone calls aren’t reimbursed either. Physicians’ reimbursement needs to be changed from procedure codes to time codes. Physicians’ seem to be the only group of professionals not compensated for their time.
“My take: Tort reform begets health reform. If the fear of baseless liability is removed, physicians will be less apt to order defensive tests or reflexively advise patients to go to the emergency room. In a perfect world, costs will be driven down leading to lower premiums for everyone.”
Well, if this is true, why not show the proof. Many states already have tort reform. How much cheaper is medicine in California, with truly draconian “reform” as opposed to a state without it?
If you believe this so fervently, why not look at the existing evidence to see if you’re correct?
The thing that is asinine about the Schilling situation is that it shouldn’t be the team doc’s decision or the Red Sox. Schilling has all of the info and presumably a doctor he trusts. The patient should always make the decision on when to operate no one else.
Most email programs support inline (e.g., SSL or TLS) encryption, which is sufficient to meet HIPAA guidelines for encryption:
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_021588.hcsp?dDocName=bok1_021588
So emailing with patients is simply a matter of education, and is indeed not prohibited by HIPAA.
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