Posted on 06/05/2015 4:51:03 AM PDT by SeekAndFind
I rarely do follow-up columns. I’m averaging one every ten years. And while my last such exercise resulted in a written apology from the White House (for accusing me of making up facts over its removal of Churchill’s bust), today’s is not a complaint. It’s merely a recognition that the huge response elicited by last week’s column, “Why Doctors Quit,” warrants both rebuttal and clarification.
Physicians who responded tended to agree with my claim that doctors are being driven out of the profession by the intrusions, interferences, regulations, mandates, constraints, and sundry other degradations of their vocation that are the result of the bureaucratization of medicine. Chief among them is the imposition of electronic health records (EHR).
I’ve also heard from people who notice how much attention their doctor must devote to filling out EHR boxes on a computer screen rather than to engaging with them during an office visit. To the point where a heretofore unheard of profession has been invented — the “scribe” who just enters the data so the doctor can actually do doctoring.
(Excerpt) Read more at nationalreview.com ...
The new president’s first official act should be to ask for the return of the Churchill bust.
Pudlo’s Postulate on database integrity: the bigger the database (1) the more likely it is to contain errors, and (2) the harder it becomes to fix them
That said, I am highly opposed to mandatory government requirements for this. My GP says that there are tens of thousands of government mandated symptom codes that must be included in the report. He, of course, has not memorized all of these. His staff now must include an entry clerk to enter these codes. Thus my record does not include what my doctor SAYS I have, it's what this clerk THINKS my doctor said. In addition, the charges must now include the cost of paying this clerk. Unelected bureaucrats in Washington DC can never improve my life in Texas.
There are criminal penalties if the doctor should click the wrong box. This will doubtless skew what he puts in towards being useless but not criminal. Why should a doctor face fines or jail for clicking what he believes is correct at the time but turns out not to be correct. (Or, any of the other possibilities that a desk bound bureaucrat can think up as a violation.)
Just this week I saw a video clip of Obama in the Oval Office. In place of Churchill was the bust of some unidentifiable black man.
The removal of Churchill was a racist act
The codes have been there for years and coders have been part of it for at least 15 years. The number of codes has blossomed into ridiculousness but the coders have been there. both for diagnosis and for procedure.
The costs: oh, $75 million upfront, maybe another 5-10 million per annum for 'support' for the crappy software.
Now this is for a hospital of size 500-1000 beds.
And of course there are kickbacks galore, for whomever buys the wasteful system.
Another way for Big Health (insurers, hospitals, pharma, gov) to bilk the patients out of more money.
This is kinda weird for me. I can see where this may be important for some people, but seeing as how I have not seen a doctor in four years, and even then I refused to give them my real SSN, I don’t really feel much personal impact.
There’s not one field of medicine, but many, each with different assumptions of what constitutes health or disease. Also, conventional MD medicine still is based on our understanding of biology of a century ago where the body is seen as an organic machine. It is too soon for EHRs.
But, but, but, EHR is a vital step towards the realization of the ultimate wet dream, SINGLE PAYER.
Medicaid for everybody!
>>That said, I am highly opposed to mandatory government requirements for this. My GP says that there are tens of thousands of government mandated symptom codes that must be included in the report. He, of course, has not memorized all of these. His staff now must include an entry clerk to enter these codes. Thus my record does not include what my doctor SAYS I have, it’s what this clerk THINKS my doctor said. In addition, the charges must now include the cost of paying this clerk. Unelected bureaucrats in Washington DC can never improve my life in Texas.
This “clerk” is actually a trained Medical Coder. It is a profession like any other that requires education, certification, and regular retraining. That job and those codes came about because of insurance fraud and demands for standardization of medical records.
I have three doctors, I had a fourth, but he retired.
Doctor 1, has an assistant follow him around and type his notes into my electronic chart
Doctor 2, dictates into a recorder while he updates a paper chart, he tells me someone uses the paper chart and the voice recording to update my chart
Doctor 3, actually updates my chart himself, but apparently the electronic chart is so complicated, he only updates a free text/memo field and someone comes behind him and actually updates the electronic chart correctly.
What a waste!
Ironically, the Medicare penalty is forcing more and more doctors to not take Medicare money. Some are even going whole hog and not taking insurance payments for routine medical care. And they are saving a fortune.
Instead of 5 or more employees, doctors only need 1 if patients pay in cash. Huge cost savings, to the point that many can charge 50% less for the same services.
While many doctors are quitting their practice altogether, those that remain can either shun government and insurance or become slaves to them. Not a hard choice, when being free of them offers so many benefits.
But HIPAA and HITECH have quickly become onerous nightmares, one that can be resolved quickly by just making them voluntary for those who reject Medicare and insurance.
And finally, after all of that, maybe we could return to “doctor patient privilege”, so that no longer can every government busybody who wants to root through people’s medical records can do so.
And pitch REAL ID while you’re at it. Worthless tyrannical rubbish.
The US politicians and the European Union want your private information.
BUSTED: TOP REPUBLICANS PUSH OBAMATRADE DEAL— THEY HAVEN’T READ!
Last year I went to a Urgent care place for a bad cold and there was a women with a laptop typing away while the doctor did her doctoring.
the “scribe” who just enters the data so the doctor can actually do doctoring.
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