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Some of you have berated me for having a negative attitude regarding Obamacare. The truth is that many good things will come out of our new healthcare, but I am alarmed by the negatives which continue to slowly drip out the cracks and insinuate themselves seemingly overnight and unannounced into our experiences with doctors, hospitals, drug companies, etc. I am concerned that the negatives will outweigh the positives and cause damage to our loved ones as they seek care.
So I will have an ongoing project to report on pluses and minuses as they occur. Here are two that appeared on my radar screen this week. Since I am no longer practicing medicine, I go by the experiences of family, friends and myself. Yes it is anecdotal but I also keep watch on the media, especially when clinical trials look at these matters, when doctors speak about the situation, and by watching the AMA reports which I receive regularly. Hopefully some of you will share your observations.
Here are my recent findings. It may not seem like much, but cumulatively, there may be substance, and I do believe that smoke might indicate a fire.
#1. A man approached the front desk at a surgeon’s office. He asked that the surgeon’s report be sent to his doctor. He was told that he would have to pay $15.00 for that service.
Whenever a specialist sees a patient, it is his obligation to send a consultation report to the primary doctor. Ideally he should also call the referring physician. I believe that communication of this type is deteriorating because of the expectation that electronic medical records will fill that void, but they won’t because they are lacking in specificity, and when our society allows time-honored individualized medical practices to fall by the wayside in the interest of time and money, quality will suffer.
Patients should request copies of their consultation notes and they should read those notes carefully. They should find a history, physical exam, test results, a diagnosis and a narrative discussion/analysis, with an individualized plan, regarding the problem; and no one should be charged for those reports.
#2. A doctor orders a blood test for a patient. He orders it, not on a whim, but because it is needed for proper patient care. The patient goes to the lab and is informed that the insurance company may not pay for the test. He is required to sign a form to indicate that he may have to pay personally.
Subsequently he receives a bill for $115.00 from LabCorps for that routine test. Evidently the diagnostic codes supplied by the doctor did not justify the test. The patient complained to the doctor’s office and asked that the bill be resubmitted by the doctor for consideration, using “better” codes. The office tells the patient that this is not the doctor’s problem. Ouch!
Sorry, but this is the doctor’s problem, and he should help so the patient doesn’t get stuck with the bill. This is an example of interference in the practice of medicine by insurance companies and indifference on the part of the doctor.