I am a surgeon and have done thousands of cases, many involving complicated spinal implants and decompressions. I try to dictate my operative note immediately after the case, but sometimes that is not possible. I have been on call and been rushed into other emergencies before I could get a break to dictate. Sometimes I was up for nearly two days and just couldnt stay awake anymore (after the adrenaline rush of surgery was over) to dictate a coherent report, so put it off till the next morning.
Medicare/medicaid fraud does seem to be a serious problem in this country (just think: crooked chiropractor...crooked lawyer...car accident...disability claim) but if I was on the jury I would,at the very least,give the surgeon the benefit of the doubt...particularly in light of the passage highlighted above.But your typical juror...IQ 95....finished 10th grade...probably envious of a successful physician...couldn't even begin to understand the realities of a case like this.
Pointed up in the original article was that the Medicare Nazis don't examine all cases; they sample, and then extrapolate. It's Aaron Swartz all over again -- they "make an example" at best, and do "extortion under color of office" at worst.
It's already having an effect. Almost all of the medical practitioners on my appointments list have sent letters or posted notices that they no long accept new Medicare patients. So now, instead of private-sector lawyers looming over a practicing doctor, you now have the "doc cops".
And the worst of it is that the docs don't get their day in court, because of the inflation of the charges.
Personally, I'd like to see a class-action lawsuit against the "cop docs" that exposes, for the public record, all the problems. Subpoena the doctors who have been victims of the extortion, with guarantees of immunity. Then the facts will get out in the open, in the sunshine.
The ultimate solution is for the medical profession to use the Standard Process (via ANSI) to codify the Best Medical Practices, and to have Congress add the force of law to those Standards. Anyone bringing a cause for action must demonstrate how the doctor in question violated the published Best Practices. No violation, no case, period. This can be extended to the "doc cops" in that coding can be associated with the Best Medical Practices so that when a doctor has to "make up" a code, he or she is protected against harrassment or worse.
Such a system would remove the "deep pockets syndrome" in both medical malpractice actions and in Medicare "enforcement".
I'm all for saving money in medicine. When I had my heart attack and subsequent hospitalization, I was overcharged $30K (not covered by insurance) because the procedures were not done for my benefit, but for the benefit of potential malpractice actions if I took a turn for the worst. I just paid off that excess over the past five years, money which I no longer have toward my retirement. So this activity has a real cost to patients.
Want to see medical insurance premiums go down? Advocate for a standards-based medical practice system, one with teeth to stop lawyers from fishing. Let's decide what's Best Medical Practice before the doctor sees the patent, let alone the correct course for treatment. Every single doctor I've seen for the past fifty years has demonstrated he or she wants to do the best thing for the patient, not necessarily the best thing for the malpractice insurance carrier.
And though I sympathize with the plight of Dr. Natale and others like him, I remember that when Medicare paid a large percentage of the doctor's full charges, and never even took a look at the quality of the chart, the physician community was only too happy to belly up to the federal buffet table and dig in deeply.
They have taken the king's shilling, and now must hie to the king's commands.
This looks to be clearly a case of “destroy any republican at any price” kind of thing. Trouble is, that most fear it happening to them, if they stand up against it. The left suffers no fools. The left leaves no witnesses, either.