One Doc’s View

August 25, 2009 7:12 p.m.

From a longtime reader …

I participated in a Doctors for America phone call tonight with the White House. Me and 2600 of my brethren listened to pretty low-level pablum from the speakers. The questions asked by those lucky enough to be chosen were also standard practitioner issues including reimbursement by the SGR and malpractice. At the end of the call, I was incredibly disappointed. Many have mentioned that doctors seem silent in this debate. I have been trying to figure out why and think I have an inkling. I think doctors, like everyone else, don’t really know how their lives/practices will change with reform.

Every time the President says that Americans can keep their current insurance, every doctor shudders. Doctors, as a group, hate no one more than insurance companies. I went to an ACC lobbying session a few years ago where Frankie Luntz spoke. When he asked the room to identify the biggest problem in their practice, insurance company interactions were, by far, the number one offender. Remember our daily lives: every insurance company requires that we are certified with them, every company has a different form to use, every company says no to our initial request. Hospitals rarely collect more than 40 cents on the dollar billed. THEY DRIVE US CRAZY. So, why not enlist us in the cause?

There are many examples of low-hanging fruit: a universal billing form, available for electronic submission to cut down on paper work and administration costs; a penalty for a claim incorrectly rejected (say a 20% penalty paid by the company when their mistake causes the office or hospital to go back and forth); formation of a public-option malpractice insurance company to lower insurance premiums (participation may require use of electronic records or other public good); standardization of electronic medical record keeping so that all systems can read the others data; reimbursement for adoption of an EMR, etc. He needs to show us why reform will improve our working lives as well as our patients lives. If he did that, there would be no louder advocates.

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