Compliance

A81D3E8A-6396-454F-8A19-430D8F126432“Better was a poor and wise youth than an old and foolish king who no longer knew how to take advice.”
‭‭Ecclesiastes‬ ‭4:13‬ ‭ESV‬‬

Compliance

My friend in the insurance industry and I discussed the relatively recent emphasis on compliance in our respective businesses and concluded that all the associated added expenses of mandated compliance have added virtually nothing to society except excess costs. Certainly I have seen so much government regulation in healthcare that is just ridiculous, another byproduct of too many lawyers. We allow non-medical people to decide what is “good” medicine, which always requires excessive documentation, documenting what I call ”e-garbage”, instead of medically relevant facts. And I can’t imagine how we plan to save years of electronic health records, since computers have made it so easy to generate volumes and volumes of senseless information. Of course, the electronic health records are astronomically expensive and have accounted for an increase in medical error deaths. Finally, while we have compliance departments that make sure we practice “good” medicine, we have far too few “hands on” patient care staff. Literally patients can bleed to death without anyone noticing while in a hospital intensive care unit, while the hospital is being compliant.

Naivety

F4615B3D-4497-476B-8BD7-8DFC6A2A475FNaivety

Naivety is having or showing a lack of experience or understanding. This definition of the word came to mind as I read my medical “news” today. Medicare is preparing to “improve patient care” by implementing a new reimbursement plan that will cut their payments for healthcare providers. Sadly enough, most people won’t question such a “noble cause.” Perhaps we can improve other entities using this same philosophy. I suggest we start with the federal government and cut their salaries to improve their work—how can they argue with their own rationale?? Sorry, I am being naive.

Law

Law
It seems to me our government has lost all perspective. Our Congress continues to make laws, perhaps in good faith, that add a tremendous financial burden to society without true benefits. For example, while there is no doubt we have a serious drug abuse problem in our country, will putting expensive restraints on the use of prescribed narcotics for pain solve it? I seriously doubt it. My friend just had a narcotic prescribed for severe pain from a shoulder injury and the drug screen required cost over $1000. (Whose lobbyist won that cash cow) Meanwhile there is a huge push to legalize marijuana. Congress can make these “trivial” laws, but cannot fix healthcare, education, or the economy. Perhaps a Presidential order or a Supreme Court ruling can intervene…who makes laws again??70444885-D7BA-4C15-876D-1513F78B2CE3.jpeg

Layers

EDA347EC-1A39-4ECE-A549-BCFBA50F0FDFLayers
When I think of layers, I generally think of the peeling off of layers of clothing or layers of skin. But today I read an amazing article (Physicians aren’t ‘burning out.’ They’re suffering from moral injury by Drs. Talbot and Dean) on the moral injury of physicians by a broken healthcare system. In my medical mind which has many years of experience, I believe the authors are exactly correct with their assessment. As this kind of honest information about physicians hits the media, I feel the first layers of this massive medical bureaucratic quagmire begin to peel—a glimmer of hope.

Physician Shortage??

88C87311-814C-487F-924F-7A7652E5F908.jpegDo we have a physician shortage? Like so many areas of healthcare, the answer is not straightforward or clear. I personally believe we do NOT have a shortage of physicians; instead, there is a lack of good distribution and efficiency.  The legal and administrative demands on physicians have limited their ability to care for the numbers of patients they should easily manage with a more common sense approach. The responses to a perceived shortage seem dangerous to me. For example, we have increased the number of medical students in school, but their clinical experience and training often suffer. It seems we are generating physicians and not educating them sometimes. I believe we have set sail on a treacherous course in healthcare and the strong winds of  overregulation are blowing us away. We need practicing physicians at the helm. Too often, physician input comes from those hired by the government, hospitals and insurance companies.