Richard Baron is a primary care physician the Philadelphia area.
He published a paper in the New England Journal of Medicine entitled “What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice,” and discussed recently on KevinMD.com. Dr. Baron conclusively demonstrates that there is a deluge of uncompensated work performed by physicians in the outpatient arena. This comes as no surprise to those of us in office practice whether it is in a primary care or a specialty setting. The only surprise is in the ability of his electronic medical record system to track the quantity and scope of this work.
Such non-compensated work is growing in volume; it is growing in intensity and it is a critical link in the continuity of patient care. Doctors know the importance of timely communication in the coordination of care. They know the reassurance it gives patients. Patients have always recognized the value of non-office visit encounters. It is a key commodity in the doctor-patient relation. Nevertheless, third party payers have resisted assigning any value to the work.
This is done at the very time that the policies and procedures payers regarding pre-approval for procedures and medications adds (exponentially) to the burden that physicians carry on behalf of their patients. Given Dr. Baron’s robust documentation isn’t it time for there to be some pay for this performance?
Arthur Chernoff is Chair of the Division of Endocrinology at Albert Einstein Medical Center.
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