Once upon a time, a little girl grew up in the Midwest.
She had a wonderful Family Physician, Dr. Mathew Creighton. He was a healer: smart and compassionate and the little girl wanted to grow up to be like him.
She wanted to be a doctor.
As she grew older, he warned her about trying to practice Medicine. It was changing.
Of course, she thought that Good Dr. Creighton was overly concerned.
Now, her poor little back hurts.
There are so many entities that have climbed up on that small back.
There are too many to list and Doctor Curmudgeon becomes angry, frustrated and depressed as she thinks about them.
There are things like MIPS (Merit Based Incentive payment system) which is a Medicare system for doctors to report data. It is complex, of course.
And HCC coding (Hierarchical Condition Category) which is some kind of risk adjustment for various disease categories.
Insurance companies that create vast amounts of paper work for her to respond to, hours on the telephone, necessity to hire extra staff to help deal with all the stooooooopid, unnecessary garbage.
There are rules.
There are regulations. And not always pertaining to the practice of medicine.
There are guidelines, not always from respected physicians that tell this little harassed physician how she should practice medicine. Of course, they don’t consider the patient. Just the “bottom line.”
Oh yes, all the insurance we must keep: malpractice, workman’s comp, unemployment.
Then there is the cost of many drugs. In our office, we can spend hours on the phone trying to get what are called pre authorizations for a patient to have the medicine they need.
Each patient is an individual. And if it’s my patient, it’s one hundred percent. This is what I was taught in med school.
What was that old song? I think it was Tennessee Ernie Ford who sang about owing “my soul to the company store.” Yeah, man. It’s happening.
Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.
SERMO www.sermo.com “talk real world medicine”