Many ask of our profession, “Are you knight or knave?”
The supposition, that there exists a dichotomy of options for the current physician, is a false one. Likely we are a little bit of both, and many shades in between. The maddening belief that the future of our healthcare system depends on this delineation is preposterous. I would more aptly characterize us as pawns.
The time for change has come.
After patiently listening to my rants and raves, my readers are starting to wonder if I have any solutions for the problems I so frequently call to attention. I have many thoughts, and a few suggestions for a path forward.
Change, I fear, will only lead to debacle if left in the hands of politicians, economists, and administrators. Our current state of misery stems from such loss of control. We didn’t enter this profession to care for the economy of a nation, we would much rather focus on the well being of each and every one of it’s members. Yet along with our brother and sister care providers, we are the primary driver and product of the system. Without us, the health of this nation falls to it’s knees.
Whether knight, knave, or pawn, no soldier would enter battle without a strong suit of armor. Yes, my fellow physicians, it’s time we banded together to protect ourselves from the fall out of this massive system makeover. This in no way changes our commitment to our patients.
As conscientious physicians actively engaged in the care of our community, I see no way forward other then the rejection of the following economically wasteful and time consuming entities:
- coding and compliance
- meaningful use
- face to face evaluations
By abolishing the above policies, billions of dollars of waste could be cleansed from the system. Make billing easy and straight forward. Each visit could be either low, moderate, or high complexity. Submission should be in a centralized, simplified, form that should not require lavish amounts of time or billing professionals. How much would medicare save if it didn’t have to process so many million complex claims?
A universal electronic medical record that houses clinical notes, labs, and radiology is all that’s necessary. The bells and whistles add very little. Don’t make physicians slaves to big data by ensnaring them in an overly complex reporting system.
HIPAA is too complicated and costly, and needs to be converted to common sense privacy laws that aren’t so dangerous and prohibitive.
I could go on, but these are a few common sense suggestions that would help the system greatly without detracting from clinical care.
Unfortunately, unless physicians learn how to use a unified voice, the likelihood for substantial change is minimal.