“To say the things he truly feels; and not the words of one who kneels. The record shows I took the blows – and did it my way.” My way would involve fewer bureaucrats making significant healthcare decisions that impact the entire country and its population at large. Both patients and physicians are taking blows from those in charge of the system who know nothing about the world of primary care.
I recently contacted her mother to inquire if she wanted her daughters’ medical chart. She said it was a gift to see her daughter through the eyes of her physician, who was there every step of the way. Medical records are more than metadata on a computer screen; they are a sacred chronicle of our enduring connection with our patients in life, and even in death. When an EMR can do that, I will be thrilled to embark on a digital journey. Until then, give me paper or give me death.
Estimates suggest that a primary care physician would spend 21.7 hours per day to provide all recommended acute, chronic, and preventive care for a panel of 2,500 patients. An average workday of 8 hours extrapolates to an ideal panel of 909 patients; let us make it an even 1000 to simplify. A primary care physician could easily meet acute, chronic, and preventative needs of 1000 patients, thereby improving access.
When did we physicians give up our freedom and basic right to earn a living?
Government and insurance companies should stop wasting dollars and cents chasing visions of value, rather use common sense and give physician outcomes the attention they deserve. Healthcare will be on better footing now and into the future.
The No Child Left Behind (NCLB) Act is to the education system what MACRA is to healthcare. Why must we keep repeating history?
We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.
In my humble opinion, that type of communication provides tremendous value. Paying more to a physician who provides services that benefit patients directly is a metric worth tracking. If physician and patient can work together by rowing in sync on the same boat, maybe we could get those in control of the healthcare system on board with us after all. Medicine is not a one-way road. You are spot on about that.
Let us go back for a moment to ponder this ingenious idea of using an index card as a medical record tool. Low cost, top quality medical care is the Holy Grail for which everyone in the field of medicine is searching. Is it conceivable we already found it, used it for more than a century, and abandoned it in light of its simplicity? Possibly.
The public should know more about what goes on in the minds and hearts of physicians. Please share this piece and start a “Doctors Do Care” Challenge. If you are a physician, write a story about a patient who changed your life. If you are a patient and a physician has improved your life in some way, please share your story with the same hashtag. #doctorsdocare.
