Tuesday, April 20, 2010

Paperwork vs. Patient Care

As the health care bureaucracy grows, so does the paperwork.

Paperwork, or documentation, takes up as much as a third of a physician’s workday; and for many practicing doctors, these administrative tasks have become increasingly intolerable, a source of deteriorating professional morale. Having become physicians in order to work with patients, doctors instead find themselves facing piles of charts and encounter and billing forms. –NYT 4/8/10

Paperwork is also taking more and more time away from patient contact and direct patient care during medical training-as much as 6 hours a day! This trend will only worsen with the recent massive increase in health care laws and regulation.

In 1965, when Congress created Medicare and Medicaid, the bill was 137 pages long… Thirty years later [the Mayo clinic] found 130,000 pages of rules they must comply with. –G-M Turner, 4/16/10

This time we are starting with a law over 2000 pages long which will create over 100 new federal agencies. Instead of spending time advancing medical expertise, how much time will physicians have to spend learning all the new regulations? (Especially now that coding errors are more likely to be interpreted as fraud and subject to felony changes. [2010HR 3590, Sec. 6402(f)(2)]

Medical training used to emphasize how to think in essentials and document only the information directly pertinent to the medical condition and care of the patient. This simplified future information retrieval–by oneself as well as medical colleagues. Now the essentials are buried in a morass of details required for payment and as protection against malpractice suits.

The switch to electronic records are no panacea as studies are showing they do not decrease administrative costs, only ”might modestly improve” quality of care provided, and may actually slow doctors down. In addition, electronic records combined with reporting requirements put patient privacy seriously at risk.

Doctors can spend time focusing on patients and their medical needs, or they can spend time being sure their paper trail is properly covered. More time on paper work means less time for patients.

Just one more way that the new laws are putting the government in between patients and their doctors.


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