Formerly the Thinking Catholic Strategic Center
Confirming Culture=Religion+Politics
Vic Biorseth, http://www.CatholicAmericanThinker.com
Private Practice Reality Today: Forced Use of Medical "Boiler Plate" Language in Medical Documentation.
Once upon a time, there were doctors, and there were patients, and life was simple, and life was good. That was then, and this is now. Today, there are multiple insurance companies and multiple bureaucracies standing between the doctor and the patient. The insurance carriers demand and receive huge amounts of money based solely upon transactions between doctors and patients. The bureaucracies expend increasing amounts of tax dollars while increasingly complexifying (if that’s a word) even the simplest transactions between the doctor and the patient. And there is a growing school of finned litigators beginning to circle, sensing the smell of money in the water, competing with a soaring flock of feathered litigators slowly circling above.
Medical insurance, like all insurance, is a form of gambling. When the employee and the employer pay the health insurance premium, they are, in truth, placing a wager. The insurance company is betting they will collect more in premiums than they will spend in claims per period of time. They pay highly specialized technicians called actuaries to very precisely compute and re-compute the odds on which they set their premium rates. Or, place their bets, if you will. It’s all based on highly complex mortality and morbidity tables that are constantly being built, updated, poked, prodded and computer-modeled by the actuaries.
But the simple odds are not the only factors in the game. Insurance companies compete with each other, and even gobble each other up. In order to come out ahead in the market competition, and not be gobbled up, they seek ways to either sell a better product, sell it at a lower premium, or both. Once premiums are cut to the lowest they can be cut, perhaps even at the actuarial break-even point, the only thing left for the insurance carriers to cut is claim payments to doctors.
The medical transaction begins with the money in the pocket of the patient, and ends with the money in the doctor’s pocket. The insurance carrier only gets a shot at it before it goes into the doctor’s pocket. To that end, we see the movement into so-called managed care with carriers and insurance conglomerates increasingly in the driver’s seat, and even acting as intermediaries, with the transaction money passing through their hands before it even gets to the doctor.
To some, the worst aspect of this is the ridiculous increase in complexity of, not necessarily the medical process itself, except that complexity detracts from it and does not help it, but the record keeping of a doctor, of his own records. It’s one of the factors increasing the complexity of medical office management and detracting from a doctor’s treatment time with his patient.
Permit me to quote from the Medical Burnout site, available at http://home.austin.rr.com/austintxmd/Pages/effect.html#Boilerplate:
Managed Care (and Medicare) are forcing medical records to become HUGE with increasing demands for documentation of minutia. The insurance plans are constantly searching for any excuse to pay doctors less, and one of the ways they do this is by downgrading the "E/M" code for the level of service the doctor provided to a patient and then paying only for a lesser code. Their stated policy is "If it's not documented in the chart, it didn't happen." The converse to that must then logically be, "If it's documented in the chart, it DID happen." Thank goodness for word processors and their ability to store endless blather and then spit it out over and over again. To illustrate how dopey this policy is, let's suppose I see one of my patients for a routine followup for high blood pressure we've had stabilized for years. Being a conscientious doctor with many years of experience I know what to check and what I'm looking for. Before managed care I might have dictated my exam into the patient's chart to read like this:
"Eyes-OK. Neck-normal. Lungs and heart-OK. Abdomen-normal. Extremities-no edema. Neuro-OK."
That's all the record I need because I know what I always check in a patient with high blood pressure, and the only time my record ever used to get more verbose was if I had found some abnormality. This made for quick dictation, quick typing, and clear, concise, easy-to-use records However, under managed care, if I don't document all the negatives (all the things I checked that were normal), I can be sure that if the insurance company audits my records, they will downgrade my charges. So now, for the same visit, I have to make a huge "boilerplate" entry into the patient chart that looks something like this:
"EYES-lids, sclerae, and conjunctivae normal. Extraocular movements normal. Pupils equal, round, and reactive to light and accommodation. Funduscopic examination reveals no papilledema, A-V nicking, or exudates. NECK-supple with no carotid bruits, adenopathy, or jugular venous distention. Thyroid is not enlarged. LUNGS-no dullness to percussion. Auscultation reveals no rales, rhonchi or rubs. HEART-normal size to percussion. The heart is in sinus rhythm with no irregular beats. There are no murmurs, gallops, clicks, or friction rubs. ABDOMEN-auscultation reveals normal bowel sounds and no bruits. The liver, kidneys, and spleen are normal size. No masses could be felt, and there is no tenderness or guarding. EXTREMITIES-there is no pedal edema. NEUROLOGICAL-cranial nerves II-XII are intact. Deep tendon reflexes are symmetrical and normoactive. Sensation and motor functions are normal. There are no pathological reflexes present."
What a bunch of gobbledegook, huh? It's all nothing but normal stuff, but it must all be typed into the record again and again
every time the patient comes in for a routine blood pressure follow-up
visit; or else I can be sure that some insurance company (or Medicare)
auditor will inspect my records, downgrade my charges, and cause me to
be paid even less than the company's normal paltry fees. Of course the
reality is that we have all this stuff canned up in our word processor;
so the transcriptionist can spit it all out with the touch of one key;
but it's the absurdity of it that's so annoying. Of course any good doctor routinely checks all this stuff, but why are we required to waste time and money and paper creating a mammoth record of superfluous "boilerplate" normals
just to please some high-school-educated insurance company "auditor"
with a "no-brainer" checklist looking for documentation she can barely
understand? Not only does all this fluff waste everyone's time and make
the charts huge, but it also makes it much harder to pick the really
meaningful stuff out of all the "filler".
Managed Care is all about paperwork and insurance company profits, not
about good patient care. If you don't do the paperwork right, doctor, [you’re not going to be paid for your services.]
(Original emphasis maintained throughout.)
Now, this is just one of many aspects of how medical doctors are being prodded and herded toward the simpler life of becoming a mere salaried employee of some MBA with perhaps a third or less education than them, and with no comparable medical expertise at all. As medical practice management becomes increasingly complex medical practitioners are discouraged from even remaining in private practice.
Those who think that a nationalized health care system will improve things are sadly mistaken. If you think things are bad now, replace the insurance rep standing between the doctor and the patient with a petty bureaucrat, and then just watch what happens next. Currently health care is supposedly free in higher-taxed Canada. Actually, what is free is the ability to stand in line for health care, not to actually get any of it. The average wait for a doctor’s appointment there is 13 months, notwithstanding the fact that the average period of a human pregnancy is only 9 months.
Perfection is not of this world, but the next, and we don’t claim to know what the answers to these problems are. What we do know is that the wrong people are in the health care regulation driver’s seat. No one who hasn’t taken the Hippocratic Oath and done his time in the medical trenches should be directing health care on such a massive scale. That’s our opinion.
(Note: Our medical billing business is now closed for lack of clients.)
Sarcastic Acronym Hover-Link Footnotes: For the convenience of those readers using devices that lack a mouse, these footnotes are provided for all webpages, in case any webpage contains any hover-links. (If you don't have a mouse, you can't "hover" it over a link without clicking just to see the simple acronym interpretation. Click any footnote link to see the acronym and a detailed explanation; "Hover" the mouse over it just to see the simple interpretation.)
SLIMC1 Secularist Liberal Intellectual Media Complex
[All Web Pages listed in Site Map by date-of-publication;
oldest at the top, newest at the bottom of the list.]
Culture=Religion+Politics; Who Are We? Vic Biorseth
The Brilliantly Conceived Organization of the USA; Vic Biorseth
Return to the BLOG page
Return to the HOME PAGE
Subscribe to our Free E-Zine News Letter
Long Live Israel
|
Long Live Ukraine
|
Long Live Taiwan
|
Long Live South Korea
|
Respond to This Article Below The Last Comment
Comment
Respond to this WebPage immediately below the last comment.
Or,
Respond to this WebPage immediately below the last comment.
Or,Publish
your own whole new Article from right here.
Wednesday, April 03, 2013
Converted Page to SBI! Release 3.0 BB 2.0.
Date: Sun Oct 05 2014
From: Vic Biorseth
Comment:
Changes pursuant to changing the website URL
and name from
Thinking Catholic Strategic
Center to
Catholic American Thinker.
Pulled the trigger on the 301 MOVE IT option June 1, 2014. Working my way through all the webpages. .
Regards,
Vic
Language and Tone Statement
Please note the language and tone of this monitored Website. This is not the place to just stack up vulgar one-liners and crude rejoinders. While you may support, oppose or introduce any position or argument, submissions must meet our high Roman Catholic and Constitutional American standards of Truth, logical rigor and civil discourse. We will not participate in merely trading insults, nor will we tolerate participants merely trading insults. Participants should not be thin-skinned or over sensitive to criticism, but should be prepared to defend their arguments when challenged. If you don't really have a coherent argument or counter-argument of your own, sit down and don't embarrass yourself. Nonsensical, obscene or blindly and doggedly repetitious anti-Catholic, antisemitic, anti-American, immoral or merely insulting submissions will not be published here. If you have something serious to contribute to the conversation, be prepared to back it up, keep it clean, keep it civil, and it will be published. We humbly apologize to all religious conservative thinkers for the need to even say these things, but the Hard Left is what it always was, the New Leftist Liberals are what they are, and the Internet is what it is.
"Clickbait" advertising links are not acceptable for posting here.
If
you fear intolerant Leftist repercussions, do not use your real name
and do not include email or any identifying information. Elitist Culturally Marxist Pure Authoritarians cannot and will not tolerate your freedom of speech or any opposition to their
rigid authoritarian, anti-equality, anti-life, anti-liberty,
anti-private-property, hedonistic, anti-Constitution, pro-Marxist, pro-Islam, pro-sodomy, pro-sin, anti-Catholic, anti-Christian, anti-Semitic, anti-male, sexist, anti-heterosexual, anti-white, racist, anti-Western,
anti-American, Globalist, anti-Nation, blatantly immoral, totally
intolerant and bigoted point of view. This Site will not publish their intolerant and unwavering screeds.
Copyrighted Material
Never be lukewarm.
Life itself demands passion.
He who is indifferent to God has already forfeited his soul.
He who is indifferent to politics has already forfeited his liberty.
In America, religion is not mere window dressing and citizenship is not a spectator sport. Do not allow our common destiny as a whole people to just happen without your input.
Seek the Truth; find the Way; live the Life; please God, and live forever.
All Published Articles
By Publication Date
Enter ye in at the narrow gate: for wide is the gate, and
Broad is the way that leadeth to destruction, and many there are who go in
thereat. How narrow is the gate, and strait is the way that leadeth to life:
and few there are that find it! Beware of false prophets, who come to you in
the clothing of sheep, but inwardly they are ravening wolves.
Jesus
Christ; Matthew 7:13–15
Related WebPages
The Purpose of this grouping of links is to gather all government health care articles in one place.
Socialized Medicine Pages
Medicine,
like education, has no Constitutional mandate and no legitimate, legal
business being addressed by federal government. Medicine, and medical
insurance, are private sector businesses beyond the scope of federal government.
Killing Obamacare does not require canceling all existing policies. Killing Obamacare means there is no mandate, there is no fine, so states, employers and beneficiaries are no longer forced to participate.
Argument against National Health Care, which is, in fact, Socialized Medicine. National Heath Care equals Socialized Medicine, pure and simple. Medical Practice is beyond the scope of government and not what our government is constituted to do.
On the forced use of medical boiler plate language rather than simple notes. The "little dictators" from insurance companies and government bureaucracies force MDs to use stilted, verbose, medical boiler plate language in their own documentation.
Who's driving the Health Care bus? Health insurance companies grading doctors? Health insurance companies grading doctors: a legitimized conflict of interest. A preparatory step toward the nationalization of the health insurance industry?
Fixing Health Care requires getting government out of it. Get government out of it, require all health insurance to be owned by and benefits paid solely to patient-beneficiaries, and let the free market do the rest.
It isn’t really Health Care. It’s all a giant pile of lies. No, it isn’t really Health Care. Nothing in Obamunism is what it appears to be.
It isn't just Obamacare; we need to kill controlled Health Care. Kill Controlled Health Care to get government and insurance out of the medical transaction.
The "Pre-Existing Condition" Progressive Marxist Psychological Trick. Insurance is protection against future misfortune, not past misfortune. How could anyone insure against past events?
Breaking Government "Sausage-Making" to Repeal Obamacare. Political Government Sausage Making versus plain and simple Constitutional Government is the sole problem with repealing Obamacare.
The Pre-Existing Condition Insurance Rope-A-Dope Political Trick. Getting the populace all exercised to grow the government over yet another political false premise involving yet another imaginary Constitutional "Right".
The evil materialist faith of global Luciferianism, Technocracy, Socialism, and Marxism
Prayer Against Wicked Ideologues Rescue us, O Lord!
System of Lies: Ideological Paradise on Earth and Why the Bloody, Violent Dream Will Not Die
Christendom and Protestant America’s Apostasy into Paganism A Timeline
The presence and influence of powers, principalities, and demons in our age of apostasy into godlessness
Nihilism…All That Exists is Matter and Energy The Worldview that Caused the Collapse of Christendom and Protestant America
Revisiting Nihilism: The Will Turned Toward Evil and the Destruction of Western and American Civilization
The enemies of God, reality, truth, western civilization and our souls Linda Kimbal column
The Last Hour and the New World Order Prayer
Our Call to Battle: Rise of the Spirit of Antichrist Prayer Article: “And this is that spirit of antichrist, whereof ye have heard that it should come; and even now already is it in the world.” (1 John 4:3)
God to Mankind: NOW Do You See the Stupidity, Depravity, and Evil in Your Hearts?
Raising the New Tower-- Occult Evolution: Antediluvian, Babylonian and Modern Expressions
Psychopathy and the Western and American Tyranny of Evil Leftist Progressive Myths
Supernatural Genesis 1-11 vs. Pagan Darwinism God and Liberty or Fallen Mankind and Tyranny
Luke 21: 29-31: Some Signs Of America's Abandonment And Spiritual Bondage
Eternal Paradise Or Hell? How And Why Both Choices Are Freely Made
Luciferian Humanists: Citing the Genesis Account is Evil "Any country grounded in Judaeo-Christian values can't be overthrown until those roots are cut ... "
Who is intolerant because ashamed: Creationists or Evolutionary Theists?
Death of the Christian God in Hearts of All Humans Why America and W. Europe are Committing Suicide
THE WORLDVIEW OF EVIL SPIRITS - an article by Linda Kimball MAGICAL MYSTERY CHURCH
Pagan-Darwinian-Materialism Redoubt of Miserable Self-Deceived Non-Self Nihilists
Americas' Spiritually Dead, Deep State and Ruling Class Nihilists Walking Dead Parasitic Idolaters
Doctrines of Demons and the Modern Pagan and Pantheist Antithesis The West's Greatest Threat
Gnosis: The Main Expression of Paganized Christianity in the New Age Inner Knowing, Self-Salvation
Our Age of Malicious Perversion How Truth, Meaning, and Reality Have Been Perverted
The Serpent's Gnostic Luciferian Elite Oligarchy and Global Powers Demonic Darkness Over the West and America
The Creation Model Versus Modern Pagan Models
2 Corinthians 10:5
What Kind of God Do You Believe In?
2 Cor. 10:5 Destroying 'scientific' arguments for false Gods
Evil Spirits, Death of God, Satanic Inversion Pagan America's Reality of Madness, Demonic Bondage, and Non-Self
Judgment and Wrath The Biblical Explanation for Madness and Evil
The Worldview of Evil Spirits Revolution, Evolution, Materialism, Nihilism, New World Order, and More
Gnosis The Main Expression of Modern Paganized Christianity
America's Transformation Into A Mystical Pantheist God-State What the Death of God Has Wrought
Message to All Wearied Truthtellers: Let Isaiah Be Your Inspiration the Remnant
The Triune God, Supernatural Heaven, Souls, Hell, and Demons Do They Exist?
Teachings of Demons The Aeon of Horus, Reign of God-Men, and End of the Christian God
Revelation 2:7" ...the closing of a steel door – a solemn, cataclysmic slamming of a door."
Systemic Nihilism: End of the Human Race Eternal Damnation of Human Souls
Infernal Apocalyptic Atmosphere Over America Disintegration into nothing
Global and Ruling Class Criminal Elitists Their Ring of Power and Pact with the Spirit of Death and Hell
Blessed is the Man Who Does Not Listen to Falling Stars Who Follow After Damnable Heresies
Darwinism: An Abomination Aborting and Rotting the Church. The falling away and apostasy from the one true and personal Holy Triune Creator God has not ended
The Evil One and the Impenitent Who Receive His Mark“. And the LORD God formed man (and) breathed into his nostrils the breath of life; and man became a living soul.” Genesis 2:7
The Fall of Mankind, the Religion of Evolution, and the Antichrist. "Pride goes before destruction and a haughty spirit before a fall." Proverbs 16:18
Why Secular Liberals Actively Promote Evil. Mentally Retarded Liberals
Cultural Marxism. The Many Hidden Faces of Living Active Communism
The Devil, the Big Bang, Evolution, Extraterrestrials and the Genesis Problem
The Ascension To Power Of Misogyny. Hatred of Women
Gnostic Chiliastic Evolution: Satan's Alternative Plan of Salvation. The Great Reset
Why Proclaiming Jesus Christ the Word Became Flesh is Offensive. The Technocratic Utopian World Order
The Divine Androgyne, Pandemonium, and the Battle for Our Souls. Satan's Rising New World Order
America's Modern Pagan Oligarchy, Aztec Gods, and Human Sacrifice. Isaiah 57 Revisited
The Peace Symbol: Occult Sign Meaning Death Against Christians. Hatred of Jesus Christ and Christianity
Americas’ Spiritually Desolate, Parasitic, Ruling Class Nihilists. Satan and Powers and Principalities
Global Oligarchy, Forces of Darkness, and the Spirit of Antichrist. Forces Darkness Within Church and State
Darwinism: Idol of mind symbolizing hatred of Triune Creator God. And Logical End of America
Is the World a Computer Simulation in the Minds of Robotic Overlords? Magic Science, Transhumanists, Gnostic Physicists.
Your soul: Cost of admission to the Progressive Pagan City of Man. New Egypt, Babylon, Sodom and Gomorrah
Iron Curtain Over American Minds Progressive Marxisms’ Ideological Utopia
Satan’s New World Order Blueprint and Key Strategy. Christian Capitulation To the Serpent's Consensus Process
Chaos, Breakdown, Demoralization, Destruction: America's New Normal. How it came about and where we are going.
Demonic Darkness: America's Invisible Wave of Evil. Staring into the abyss
Cain, Marxism, Leftism and America's ruling class of 'superior' humans. The dragon they have in common
Modernist Christians in a Man-Centered Universe. Scientific Neutrality and Biblical Deconstruction
The Connection Between Baphomet and Why Researchers Are Creating Interspecies Embryos. 2 Corinthians 10:5
Isaiah 57 revisited: America's progressive pagan elites. Staring into the Abyss
Evolutionary Theism Implies That Christ is Wrong About Creation. "For if you believed Moses, you would believe Me, for he wrote about Me. But if you do not believe his writings, how will you believe My words?" John 5:46-47
Utopianism. Progressive Utopian Cultural Marxism Poisoning Minds, Churches, Schools, Politics
Acts 17:18-19-modern pagan and pantheist antithesis of the Word of God Ecclesiates 1:9 "What has been is what will be.."
Trotsky's Permanent Revolution From Hell In America. The Soviet System in America
Why Transgenderism Is Being Forced Upon America and Our Children. The Divine Androgyne
The Evil Eye Of Envy: Why Being ‘White’ Is Offensive To Some People. No Vice Worse Than Envy
Absolute Nothingness and Non-Self: The Reigning Worldview of Global Power Elites and Western Ruling Classes
What is Evil? Man-made alternative realities
Trump is Destroying Reagan's Legacy By Cliff Kincaid
Trump is a Marked Man By Cliff Kincaid
Terrorist Attack in Baltimore By Cliff Kincaid
Moscow Terror Attack is Another KGB Operation to Fool the West
Obama’s New Nazi-Communist Alliance
On the "Days Of Rage" Planned For The 2024 Marxocrat Party Convention Some of you just couldn't believe that the formerly Democrat
(Confederate) Party had already gone totally Communist before the 1968
Party Convention
Making Russia Great Again By Cliff Cinkaid
De-Nazification and De-Communization in Russia The The mutual non-aggression Hitler-Stalin Pact, which started World War II, has been carefully “forgotten”
Climate Emergency To Produce a New World Order By Cliff Kincaid
The Next Phase of Obama’s “Permanent Revolution” By Cliff Kincaid
Evil in the White House In This War, The Enemy Is In The Ranks, Standing Right Next To You
Satanism, Communism: What's The Difference? Look To The Roots Of Communism
Fox Is the Leading "Trans" Channel There are some rather peculiar goings-on at the Fox News Channel.
Trump and His Communist Enemies The Demonized Joe McCarthy Turned Out To Be Accurate In Everything He Claimed: Fox News Is Wrong About Him And About Much More
The Five Stooges on Capitol Hill They Think We Need Even More Doped No-Hopers In The American Intelligence Community
The Biden Doctrine of Demoralization and Defeat By Cliff Kincaid
A Republican Church Committee? Do Pro-American Republicans Even Know Who Frank Church Really Was?
A Top to Bottom Housecleaning of America When we clean our house, my wife has a slogan, “Top to bottom,” meaning you have to target the whole house. The same advice applies to nations.
China's Mass Murder Experiment Phase Two
Bury The Dead And Move On Fuggedaboutit!
9/11 Truth This is the real 9/11 Truth: Our “intelligence” agencies are infiltrated.
Moving Toward Gorbachev’s “World of Communism” It's called the Monster Plot.
The Errors of Russia, the Dupes of Putin, and Another Holocaust Can The Increasingly Faithless Free World Be Saved From Russia?
World War Quietly Conquering A Distracted and Blithely Unaware World. Could it actually be Satan's world war on despised humanity?
Stand With Ukraine Against Russia and China By Cliff Kincaid
Tucker Carlson Carlson Gets His Comeuppance. Tucker's View: It is not moral for us to intervene in support of any nation's (Ukraine's) democratic self-determination and against Soviet military expansion.
The Need for Secure Borders. Have we so easily forgotten what borders are for? Have we forgotten that evil exists in the world? Have we forgotten how to keep apart from this evil?
Can Ukraine Survive Putin and Biden? Can America? Can the Free World? Can Faith in God?
The Soviet Union: Back From The Dead The Return of the Evil Empire
Could an American Surrender be in the offing with Biden at the wheel? Is this not the perfect time for Communism to strike, with Commies now governing America, China and Russia? What would Biden do?
Abortion and Communism. If you ever wondered where all the popular abortion-contraception-sexuality-perversion nuttiness came from, look to Marx's Communist Manifesto.
The Secret Life of Martin Luther King, Jr. A life almost totally at odds with his reputation as a minister of the Gospel.
"We belong to the Church militant; and She is militant because on earth the powers of darkness are ever restless to encompass Her destruction. Not only in the far-off centuries of the early Church, but down through the ages and in this our day, the enemies of God and Christian civilization make bold to attack the Creator's supreme dominion and sacrosanct human rights." --Pope Pius XII
"It is not lawful to take the things of others to give to the poor. It is a sin worthy of punishment, not an act deserving a reward, to give away what belongs to others." --St. Francis of Assisi
Truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is.—Winston Churchill
The smallest minority on earth is the individual. Those who deny individual rights cannot claim to be defenders of minorities.—Ayn Rand
If you can't find the page you're looking for, try the
SITE MAP.