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A Physician’s New Reality: Patients Ask Me to Break the Law
Pajamas Media ^ | 11/24/2012 | Dr. Peter Weiss

Posted on 11/24/2012 8:49:23 AM PST by SeekAndFind

Obama won, Obamacare is the law, and, as my wife says, I will just have to learn to dance to a new song.

Now, don’t get me wrong, Obamacare is awful. Forget all the “free stuff” it provides. Children covered on their parents’ plan until 26 years of age? A scam, making young adults — excuse me, children — pay for complete, comprehensive health insurance when all they need and should pay for is major catastrophe insurance. Then there is the “annual ” or “preventative” exam, which according to Obamacare is “free.”

You gotta love this stuff. I wish I had the chutzpah of the people who wrote Obamacare. What they did not tell you, and I am, is that it covers absolutely nothing more than the bare minimum.

I have now posted a notice in my office and each exam room stating exactly what Obamacare will cover for those yearly visits. Remember Obama promised this as a free exam — no co-pay, no deductible, no charge. That’s fine and dandy if you are healthy and have no complaints. However, we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code — insurance will not cover any new ailment under that code.

If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.

You, the patient, will then have to make a decision.

Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss.

This happened to me personally, as a patient, when I went for my physical. It is the law. If you are complaining of a new problem, then you have to reschedule, since Obamacare is very clear as to what is covered and what is not. Obamacare — intentionally — makes it as difficult to be seen and taken care of as possible.

Patients can be very tricky. I have had patients make an “annual” exam, only to want to discuss and be treated for another ailment. I can’t do it.

I can hear the complaints from you guys already — I become the bad guy. “Why don’t you just take care of the problem, and not bill out any different code? You’re a rich doctor, and we are entitled to free stuff.”

It doesn’t work that way. First, doctors are not rich and, like most of you, actually work terribly hard for a living. Second, Obamacare is the law — and as I said earlier, we are audited all the time now.

Also — I don’t ask for free gas when I go to the gas station, or ask for free food from the supermarket. Additionally, Obamacare has a 23% cut in Medicare reimbursement to doctors and hospitals.

These lower payments won’t cover the cost of staying in practice to take care of the patient.

Private doctors are becoming a thing of the past. By 2014, less than 25% of physicians will be in private medicine. Obama was right in stating you can keep your doctor if you want to — the problem is he or she will rarely be available.

On top of all of that, doctors will be obligated — that’s right, obligated — to talk to you about things you may have no interest or need to talk about.

You may just want to have a pap smear or check your cholesterol. However, I am now mandated by the government to talk to you about your weight, exercise, family life, smoking, sexual abuse(!), and even to ask if you wear seat belts. And I am mandated to record your answers.

I am a physician. But I need to tell you to wear a seat belt and then record your answer.

I have received interesting responses from my patients since I put up the notice. Almost all are supportive and totally understand. The very few who complain? The same patients who always ask for free samples, who always complain that we do not validate parking. These are also the same patients who call my office and ask for free samples even when they are not even being seen.

Obamacare and its 2,000-plus pages are here to stay. I will still give my patients 100% of my time, energy, and knowledge. I still love being a doctor — my patients’ doctor. I will, however, abide by the law and follow it to the letter. I will have to learn this new dance. “Free” has its price.


TOPICS: Constitution/Conservatism; Culture/Society; Government; News/Current Events
KEYWORDS: healthcare; obamacare; obamacareproblems; patients; physician
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To: patriotsblood
Does anyone in FReerland know whether or not doctors are mandated to ask patients about their ownership of firearms?

I know we are not.

I know it is "standard of care" for parents of children (per American Academy of Pediatrics), but all that means is that a private legal cause of action (malpractice) is created against the pediatrician or family doc who doesn't ask IF a child then shoots himself or someone else.

So far, "standard of care" has no significance in licensure or other government actions.

It would have been much better if Florida or other states legislating about this matter had banned lawsuits against doctors who don't ask, rather than banning asking the question.

Banning the question is almost certainly unconstitutional, and it covers situations where you HAVE to ask (suicidality, homicidal ideation).

Banning the lawsuits would remove the "standard of care" problem, but, since the lawyers make the laws, that will never happen. Can't leave money on the table, as they say.

21 posted on 11/24/2012 9:15:37 AM PST by Jim Noble (Diseases desperate grown are by desperate appliance relieved or not at all.)
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To: patriotsblood
Does anyone in FReerland know whether or not doctors are mandated to ask patients about their ownership of firearms?

I know we are not.

I know it is "standard of care" for parents of children (per American Academy of Pediatrics), but all that means is that a private legal cause of action (malpractice) is created against the pediatrician or family doc who doesn't ask IF a child then shoots himself or someone else.

So far, "standard of care" has no significance in licensure or other government actions.

It would have been much better if Florida or other states legislating about this matter had banned lawsuits against doctors who don't ask, rather than banning asking the question.

Banning the question is almost certainly unconstitutional, and it covers situations where you HAVE to ask (suicidality, homicidal ideation).

Banning the lawsuits would remove the "standard of care" problem, but, since the lawyers make the laws, that will never happen. Can't leave money on the table, as they say.

22 posted on 11/24/2012 9:16:24 AM PST by Jim Noble (Diseases desperate grown are by desperate appliance relieved or not at all.)
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To: SeekAndFind

Heh... I always ask the plumber to break the law when he installs a new faucet in my kitchen or bath. “Can you get the government flow restricters out of there for me?” It takes the plumber half-a-minute to do something it takes me half-an-hour to do. Amazingly, some plumbers are hesitant to do it for fear of breaking the law!


23 posted on 11/24/2012 9:16:56 AM PST by Lancey Howard
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To: Cletus.D.Yokel
Not enough doctors? Okay, lets mandate a lowering of standards such that more “deserving” students can play doctor.

That's already in the bill.

Didn't you read it?

24 posted on 11/24/2012 9:19:07 AM PST by Jim Noble (Diseases desperate grown are by desperate appliance relieved or not at all.)
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To: Cletus.D.Yokel
Not enough doctors? Okay, lets mandate a lowering of standards such that more “deserving” students can play doctor.

That's already in the bill.

Didn't you read it?

25 posted on 11/24/2012 9:19:58 AM PST by Jim Noble (Diseases desperate grown are by desperate appliance relieved or not at all.)
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To: patriotsblood

Centricity (the Mercedes Benz of EMRs sold by GE) has a field for it in the Pediatric History. So far, AFAIK, it isn’t required to be filled out. When I used Centricity, I never did.


26 posted on 11/24/2012 9:23:03 AM PST by wastoute (Government cannot redistribute wealth. Government can only redistribute poverty.)
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To: stanne
"This MD is just whining."

That's what you call it when a person objects when the govt. forces him to act against his best professional and ethical judgment ? Whining?

27 posted on 11/24/2012 9:23:35 AM PST by Mrs. Don-o ("The first duty of intelligent men of our day is the restatement of the obvious." George Orwell)
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To: Cletus.D.Yokel

I could go on and on. I will say this. YOung physicians have been so brainwashed they think there is such a thing as “Right to Healthcare”. I’m serious. If one person can make a claim on another’s productivity that condition is called slavery.


28 posted on 11/24/2012 9:26:58 AM PST by wastoute (Government cannot redistribute wealth. Government can only redistribute poverty.)
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To: SeekAndFind

“Obamacare and its 2,000-plus pages are here to stay. I will still give my patients 100% of my time, energy, and knowledge. I still love being a doctor — my patients’ doctor. I will, however, abide by the law and follow it to the letter. I will have to learn this new dance. “Free” has its price.”

This is defeatism. Cooperating with the regime by “learning a new dance” only strengthens the regime and tyranny. I guess for this sell-out doc, free does have its price, he is giving up his freedom to practice by complying with these inane rules that will probably impede care.

I have stopped seeing traditional Medicare patients (but will still see Advantage plans for now). I am still in private practice, and I am not planning to go to electronic records. Doctors are not required to ask patients about firearms (but I do enjoy talking about guns when the subject comes up).

There are 3 general paths now for doctors: retire/other profession, join a hospital group and become a part of the machine, reduce exposure to government insurance and go to cash or hybrid insurance/cash with other revenue streams. All 3 options will result in a lower physician supply with reduced access.

But as for Dr. Weiss, I think that he should give up medicine and work for John Boehner. Dr. Weiss might be the perfect rino physician.


29 posted on 11/24/2012 9:29:44 AM PST by grumpygresh (Democrats delenda est; zero sera dans l'enfer bientot)
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To: SeekAndFind

I saw a story video about this the other day. The woman said she was charged for asking too many questions.

http://minnesota.cbslocal.com/2012/10/19/questions-can-trigger-split-visit-charge-at-docs-office/

What Obamacare has done for me...my wonderful GP says he is retiring, even though he’s in his mid 50’s. My MS neuro at the Univeristy has rather hastily left his position and is now leading research at a major pharmaceutical...leaving behind no MS specialist to take his place but they’re “searching.” My hospital of choice, 80% of the neurologists in my city (along with a slew of other doctors, but I’ve just researched neurologists), and the lab where I get my tests done, are all in a dispute with my insurance carrier due to increased fees, etc. So as of the end of this month, if no agreement is reached, my choices will be very limited when it comes to neurologists (and I have a suspicion that Obamacare plays into the “price war” in some way).

The “you can keep the doctor you have now” didn’t mention “but they probably won’t be practicing.”


30 posted on 11/24/2012 9:36:59 AM PST by memyselfandi59
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To: Jim Noble

Oh, that’s coming. We take good doctors for granted. Research, equipment, pharmaceuticals, educated and moral doctors, no.
Long waiting times, moral dilemmas, lack of care for the old, infirm, addicted, obese and all others who depend on MDs instead of their own self reliance, are just some of the things we’ll have to get used to in addition to having absolutely no privacy.

That’s before we lose our doctors who will retire ASAP, to be replaced by whom? Incurring a $250 - $500K debt before a 4 yr med school, then a 3 year sleepless lifeless internship to work for what $200K for the government in which they can’t practice medicine but who must act as privacy intruders for the gov’t?

no


31 posted on 11/24/2012 9:42:50 AM PST by stanne
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To: SeekAndFind

So if you show up at the doctors office for a yearly exam and die during your exam how does he code it? ;-)


32 posted on 11/24/2012 9:44:12 AM PST by Average Al
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To: Slyfox

Yep, I’ve had that as my tag line for quite some time now.


33 posted on 11/24/2012 9:46:17 AM PST by Las Vegas Ron (Medicine is the keystone in the arch of socialism)
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To: stanne

“Doctors should have been way out in front on this and this article is four years late.”

I agree, but the left did a good job demonizing ‘those rich doctors’, and defending our profession was made to seem entirely self-interested and ‘about money’. In addition, those docs who have a soap box tend to be those who don’t see patients and who spend all their time as politicians, ‘leadership’ in professional societies, making the rest of our lives miserable while they prop themselves up. It’s a long story, but the minute the idea that ‘medicine is a right’ was allowed to be voiced without vociferous rejection, it was only a matter of time until they pushed to make it a legal entitlement.


34 posted on 11/24/2012 9:48:24 AM PST by pieceofthepuzzle
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To: Ditter

Sounds like time to find a new doctor.


35 posted on 11/24/2012 9:49:56 AM PST by BlackElk (Dean of Discipline, Tomas de Torquemada Gentlemen's Society. Broil 'em now!!!)
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To: SeekAndFind
How is ownership of firearms related to requiring a colonoscopy?

A better question is what does your colon have to do with being a good obedient serf?

36 posted on 11/24/2012 9:55:47 AM PST by Vince Ferrer
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To: memyselfandi59
So as of the end of this month, if no agreement is reached, my choices will be very limited when it comes to neurologists (and I have a suspicion that Obamacare plays into the “price war” in some way

Two words: medical tourism.

37 posted on 11/24/2012 9:59:48 AM PST by Vince Ferrer
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To: SeekAndFind

My date for the Death of America is not election 2012, but the Saturday night at midnight that Obamacare was rammed through.

This election was just the single instant in US History when we could have elected a GOP president and Senate to overturn Obamacare.

We failed and now our fate is sealed and the Death of America is a certainty. A “when” not an “if”.

My guess is that both parties are in on it.

I am so grateful to the Lord God that I was not born any later than I was. It will be bad enough to have to be subject to Obamacare and the moderate socialism I will have to endure these last 20-30 years of my life, but your grandchildren will endure a lifetime of oppression.

My prayers are for them. We gave away the American Dream. America died on my watch. I didn’t cause it, but it makes me sick to my stomach that America died on my watch. Right on time really — 200 years to that tipping point when the immoral, ignorant masses vote for whichever sheister promises the most apparent free goodies.

Free goodies for all, freedom for none.


38 posted on 11/24/2012 10:05:37 AM PST by Freedom_Is_Not_Free (Free goodies for all -- Freedom for none.)
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To: stanne
Doctors should have been way out in front on this and this article is four years late.

And they could have done what?

I know many doctors and have 4 in my family. Absolutely none of them or their partners or their doctor friends support Obamacare and never have.

As for this doctor whining, he's spot on. My brother-in-law, an Oncologist on Detroit's east side had to leave his medical group and go on staff at a local hospital he worked out of because medicare and medicaid were not reimbursing him for the full cost of the chemo therapy drugs he had to administer to his patients......

And as a side note, most of the born and bred American doctors are vehemently opposed to Obamacare, its the foreign doctors that come from countries like India and the middle east who become Democrats and support socialized medicine......

39 posted on 11/24/2012 10:08:35 AM PST by Hot Tabasco (Jab her with a harpoon.....)
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To: Vince Ferrer

The government has doctors by the tit. You don’t get to retain your license if you don’t play by the rules.

nobamacare...stay healthy or die.


40 posted on 11/24/2012 10:08:55 AM PST by ogen hal (First amendment or reeducation camp?)
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