ICD-10 Supporters?
Again I thought I was being fooled by the folks at Gomerblog but this was in hard print so I knew it was real. In the Jan 10 issue of Medical Economics there as a small article talking about the American Health Information Management Association (AHIMA) who rallied supporters to tweet members to ask them to NOT delay the ICD-10 anymore. They were doing this to fight the AMA who themselves were writing in to Congress to delay the ICD-10. I guess AHIMA used tweets, instead of a letter campaign, to show how hip they were? Anyway, this group’s main reason to drop the ICD-9 coding system is because “it does not meet the needs of today’s healthcare system”. Really? Where is the proof that more intensely coding will help care? Even better, where is the proof that you need to code at all? Doing direct primary care has removed me from these shackles and has only made me realize what a waste of time coding is. The bottom line is that all AHIMA wants to do is save or expand its members jobs. That’s called self-preservation. Unfortunately, all the ICD-10 will do is drive another round of doctors into retirement or direct care. That’s called self-preservation too.
With the aging of the baby-boomers and the doctor shortages that cannot meet this demand it makes more sense to decrease the time intensive, non-clinical regulatory burdens that slow doctors down. ICD-10 does not do that.
SAY NO TO THE AMA AND THE ABFM!!!
“I’m mad as hell and I’m not going to take it anymore”
Post this everywhere just to see what happens.
ICD-10 will be a big improvement over ICD-9.
Hahahahahahahahahaha …!
I’m sure ICD 10 has another purpose, generating mega-data. Why else would a subsequent visit for a turtle bite have a different code than the first? Of course garbage in equals garbage out. Do you really know that turtle bite wasn’t already seen by someone else? And unless you get more money for severity, how much time are you going to devote to someone else’s research project for free? No doubt the flawed mega-data will be used to prove how some capitalist or bureaucrat needs more power and money, and hand’s on health care providers less, as data can pretty much be manipulated or misinterpreted to say whatever the owner wants. That seems to be what happened with the IOM data about health care mistakes, with the rare wrong side surgery being constantly highlighted and the definition of mistake rarely if ever quoted.
We need the lates Lewis Carroll & Hunter Thompson to write the screenplay.
“Where is the proof that more intensely coding will help care? Even better, where is the proof that you need to code at all?”
The devil in the system is always in the details. Every new and helpful option manufactures an unspoken decision made at a place and time far from the doctor and the patient in the clinic.
The nonsensical assumption characteristic of pre-literate societies is that the NAMING of something somehow connects the namer into a position of power over that thing’s existence. Only pray to the Lightning-God, and he will answer your prayers and keep you safe.
In truth, the name (or number) of a thing is only as important as it is useful. “Bright’s disease” or “lumbago” convey a vague and hazy meaning about a person’s medical condition. But it is a myth to assume that coming out with a crisper definition of a thing somehow conveys more power over it. Often, the common cold is never codified down to the viral species – in general, such determination lends no assistance to the care of the patient. Similarly, in rheumatology, the classical diseases are like telegraph poles between which the wire is strung. Some patients may typify Lupus or Scleroderma in its classical form; many more have a CREST-y myositic and non-particular inflammatory expression of their disease, notwithstanding the insistence that their misery conform to those classifications lain down by the ICD lords.
What happens conceptually in such a case? Do we exclude the non-standard patient off in the twilight, only recognizing the canonical and non-variant forms of disease? Are “diseases” somehow capable of being classified in to one of a finite and mutually exclusive set of enumerable Forms that we can look up on a list?
Most good researchers of all sorts claim that they use disease criteria not for diagnostic ontology, but rather for tightly illuminating definitions that segregate patients in THEIR OWN field of research. A person, for instance, who does not present much anxiety may well have PTSD; most commonly, people with PTSD do. “Anxiety” may be a criterion for choosing patients for research; it does not have any purpose in allowing a mid-level to wave away the diagnosis of PTSD “because you have no anxiety.”
People are not widgets, you are right. And after sixty-some years of telling their people that they WERE widgets, powerless and under control, the various Eastern European governments were shocked to see that their “loyal widgets” were in fact men and women with legs (and guts) to walk off the job. What will healthcare do when the patients go on strike?