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Say no to bureaucrats and yes to direct care

Josh Umbehr, MD
Physician
May 17, 2014
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Yes, it really is time to revoke the health care mandates issued by bureaucrats who are not in the profession of actual healing.

Daniel F. Craviotto Jr. writes in the Wall Street Journal, “In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship.”

Craviotto, Jr. is a doctor who embodies the fight of direct care. How we interact and treat our patients truly is the practice of medicine. There’s a problem with the rising cost of health care. (For starters, Oregon spent over $1,000 per subscriber on just a website to sign up for coverage that might not even provide a doctor.)

And there’s a larger problem when the individual physician in the trenches doesn’t have a voice in the debate. Bureaucrats are telling doctors what they can and can’t do.

And that needs to stop.

As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. Does anyone endure the gauntlet that is a residency program — 10+ years of training — to do anything except their best work?

Yes, the demands on physicians are great, and many of our families pay a huge price for our unwavering commitment. But shouldn’t our nation take great shame in knowing fee-for-service docs tack on 2+ hours of transcription every working day just to get paid, maybe, for the work they’ve already done?

How can bureaucracy, split between so many non-practitioners, own up to the cleavage of time that it brings upon the very people working to keep our nation healthy?

When do we say damn the mandates and requirements from bureaucrats who are not in the healing profession?

How do we stand up and say we aren’t going to take it any more?

For starters, we say yes to direct care.

We say, stop, every time a doctor joins the movement, every time a doctor pledges to make that transition (and makes a plan to help their patients through it).

We say it every time a patient says, “Give me affordable primary care.”

We say, stop, when we cut the red tape: Offer affordable services for cash, make insurance something that’s only used in real emergencies, and render EMR regulation and meaningful use incentives null and void.

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The Centers for Medicare & Medicaid Services do say that fee-for-service docs have to use an EMR or they’ll be penalized with lower reimbursements in the future. Some meaningful use criteria from Medicare tell physicians what they need to include in the electronic health record or they won’t be subsidized the cost of converting to the electronic system and we will be penalized with lower reimbursements.

Meanwhile, keep in mind: EMR vendors are raking in the dough and saving us nothing.

Meanwhile, across the country, fee-for-service doctors waste precious time filling in unnecessary electronic record fields just to satisfy a regulatory measure.

Is that the best use of time for a highly-trained individual?

Physicians are tired — tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way they practice medicine.

And as we know, physicians top the list of professions with the highest suicide rates.

Yes, we’re irrational humans. But we’re doctors, too. So let’s be scientific — saying that EMR machines are literally making doctors kill themselves is a stretch. But, if we have the data that says, “We work in a profession where suicide is common, and we promulgate activities that are totally meaningless, i.e. hours of transcription that could be spent with loved ones,” how is this ethical?

No other profession would put up with this kind of scrutiny and coercion from outside forces.

The legal profession wouldn’t.

Labor unions wouldn’t.

So why should we?

Josh Umbehr is founder, Atlas.md.

Image credit: Shutterstock.com

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Say no to bureaucrats and yes to direct care
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