Ways to screw doctors and make them quit

Ways to screw up doctors and make them quit


In the beginning, God created Medicine. A system mandating physicians, to spend most of their time documenting every detail of every visit to prove "we have done nothing wrong" so patients don't win when they sue.

And God saw that was good.

This is a fact, whether doctors deny it or not. The main focus of the majority of physicians is documentation, running tests, and getting consultations. Defensive medicine to protect themselves from medicolegal litigation.

Of course, it is a costly way to practice medicine, and it will bankrupt the system. BUT, who cares, I just want to cover my butt!

It is very common among doctors to document
"discussed with Dr. So and So," "The patient is notified," "Explained to the patient and the family," " The patient did not follow up," " The patient is noncompliant," or "the patients declined colonoscopy." These all are nonmedical, but just paranoid statements inserted in most medical reports, just in case a patient or his family denies explained condition or treatment, claim negligence or reduced level of care.
We actually spend more time teaching medical school and residency to patients and their families more than the time we spend treating them in the hope they do not sue us!

On the second day, around 2009, the God Medicine created Obama, and EMR, for the sake of legibility and to avoid medical errors, and God saw, that was good.

It took doctors months and months of extra work to get used to the new system. It still takes longer time especially for doctors who are not used to typing. They said they will pay incentive for doing this but they were very creative about, how not to pay. Actually, I got paid about 6% of what they said they would have paid.

On the third day, the God Medicine created the Meaningful Use Criteria (more accurately, The Meaningless Criteria) and God saw that was good.

They cut our pay when we didn't fulfill those Meaningless Criteria. I never could satisfy them, criteria because they are meaningless. So, I gave up. They disqualified me for variable reasons like; may patients did not send me enough emails, or they made a mistake.

Even though I used EMR from day one in my private practice, I wasn't paid because I missed the criteria by 0.5%.

Medicare increasingly cut my pay by 2% each year, year after year. We, doctors, spend an average 66 cents on the dollar to run the practice. The 2% pay cut/year is actually a 6% profit. This is on top of not getting paid for other bizarre reasons. I found out that I haven't been paid for services I have been providing to my patients over 3 and 4 years. Medicare demands me to bill the supplemental insurance, and the supplemental insurance requires me to bill Medicare, and I get lost in the middle. To save me an aneurysm or at least hemorrhoids, I accepted not to get paid, and I stopped seeing Medicare patients.

On the fourth day, the God Medicine created ICD 9 which had 10,000 codes representing 10,000 diagnoses. Doctors are not paid when not using a specific code. There were payable and non-payable codes for the same diagnosis. Over the years, every time Doctors mastered a payable code, it became non-payable the next year and so on.

So, On the fifth day, the God Medicine created ICD, 10 which has 40,000 codes. And the dance around payable and non-payable codes continued, but at 40,000 code complexity.

On the sixth day, the God Medicine created the "Annual AV" reports for all senior patients. It is a complex report, maybe 10 pages long/patient. It is a tedious job, and Sometimes it takes one to two hours per patient.

For just an example, doctors need to document if a patient had a cataract, if so, in which eye right or left, has it been surgically corrected or not? If yes, WHEN?? Doctors have to go back and dig into the charts to document the exact date a patient had a god damn cataract surgery! One year, I was so frustrated because all my reports were returned for corrections. So, I decided not to do these damn reports.

I was penalized by losing a very very big chunk of money, over $45,000 which included all my "bonus".

The next year I spent all of my time doing those reports.

By the way, each year, the AV reports requirements have been changing and increasing. However, doctors are still mastering them.

On the seventh day, you would think the God Medicine rested or took the day off, But NO, he created a new thing to de-valuate physicians. On the seventh day, the God Medicine created The Star System, like in hotels or preschool.
Basically, when doctors lose stars, they get paid less. Needless to say, it is impossible to have all 5 of them, stars.

If patients eat a lot and do not lose weight doctors lose stars. If they eat a lot and do not control their diabetes, doctors lose stars. If they do not take their medicine and blood pressure go up the roof, doctors lose stars. If Patients refuse to get their ass holes propped, doctors also lose stars too.

The crazy thing is, you get 1 to 5 stars per category no matter how many patients are in the category.

So, if a doctor has a 100 patients in the Diabetes category and he or she fulfills Hgb A1c control he gets 5 stars. However, if he has 1 undocumented Rheumatoid patient (like those immigrants), he gets 1 star and becomes a 3-star doctor instead of 4.96039 stars.

Guess what? This stupid and mentally retarded star system will only lower doctors' pay!

So, in conclusion, doctors spend way more time struggling to collect and record data for the CMS than the time actually spend treating patients.

The only way to keep up with this is to hire people to do all the bureaucratic nonmedical work and pay them most of the income

It helps when to lose autonomy and get employed by a hospital, or incorporation and take it .....Yes Sir, Yes Sir, paycheck to paycheck.

I don't know what is the God Medicine is doing with all these data, but for sure I know it did never improve the healthcare outcome. It only took away doctors time and effort from the patient care.

Healthcare in America costs 10s of times more than anywhere in the world yet the quality is lower than many countries in the world like in France, England, Newzealand, Australia, and Canada.
Doctors, especially Primary Care doctors get pay cuts in so many creative ways.

Doctors get new suffocating time-consuming regulations and get DE-VALUATED by Medicare, Insurances, PPOs, HMOs, Medicaid, HIPAA, Prior Authorizations, One Minute Clinics, Meaningful Use, needless Pharmacy Reminders and Drug Warnings which does nothing but waste our valuable time. They all are devaluating physicians and making the practice of medicine impossible. They control and reduce doctors income, and force physicians down to become just ordinary employees. What a waste of expertise, intelligence, and a lifetime of hard work