Bureaucracy Killed the Family Physician
Here is a nice summary in the Medical Economics magazine of why we are having such a shortage of family docs. All of it, by the way, was predicted by me over the past 15 years with proof in this blog. It is summarized as:
- Bureaucracy
- Red tape
- More bureaucracy
- Pay-for-performance
- Quality indicators
- Metrics
- More red tape
- Even more bureaucracy
All of this was created and imposed upon doctors by the federal government. And the beauty is that some people think that the one who will fix this all will also be the government. Really? Child, please.
Don’t leave out the ACGME and the specialty boards who discovered that MOC requirements were highly profitable and didn’t care if they took away from patient care.
Please don’t leave out the AAFP. They were a relative bit player, but they were a nice useful idiot to provide cover for the bureaucracy.
“the AAFP. They were a relative bit player”
Oh, I’d give the AAFP (and the other medical societies) a lot more credit than that. I can assure you it wasn’t a member of congress who came up with the god-awful PCMH and then decided to give NCQA control over it – that was entirely the AAFP’s baby. CPT and RUC – straight from the AMA. All of these disastrously bad ideas start with the non-practicing physicians who were couldn’t hack patient care and found cushy homes in our academies.
We have met the enemy and he is us.
Ditto,
What I’d like to print is something of the lines of holding a gun to the heads of the
powers that be and give them 3 choices.
1. You walk away no questions asked.
2. You agree with the rank and file of what the problem is and work to fix it.
Some of that will entail personal responsibility of patients and relieve
Practitioners of all this bogus uncompensateable paperwork/MOC etc.
3. We pull the trigger.
Somehow I believe 100% would opt for number one or two.
Who was it who said, “I’ll make him an offer he can’t refuse.”
My opinion is it will take something radical like this to save primary care medicine.
Going into it is as good as being condemned to Hades or purgatory. Well, at least that only
last as long as your career!
And, don’t forget the HITECH Act, which gave us, drumroll please…the ubiquitous EMR!
I know it’s part of the bureaucracy, but thought it deserved special mention.