Paging Pres. Hoven: The Peasants Would Like A Word by Pat Conrad MD


(Ok, the docs in the pic are all Israelis, but they were on strike and looked pissed, so I used it ~ P)

In the March 28th post, King Doug told us that authentic doctors have to fight back.  Now we could (insert gratuitous “Animal House” line) do it with conventional weapons, but that could take years and cost millions of lives.  A more workable solution was offered by fellow subject Sir Lance-a-Lot, namely, a strike.  Or slow-down, or sick day, pick your euphemism.  It’s a good idea, and if you missed it, go back and read it.

In the 3/1/14 issue of Family Practice News, an article caught my eye:  “Physicians face steep ICD-10 price tag.”  The article quotes heavily from that Vichy of health care, our beloved AMA, which funded an impact study through the Nachimson Advisors on the imminent ICD-10 switch.  Staff training, new software/hardware, testing, crates of Maalox, and increased liquor bills are now all projected to be THREE TIMES higher than predicted in 2008.  The firm hired by the AMA now estimates ICD-10 costs to range between $56,000 and $285,000 for – deep breath – small practices.  By “small” they mean 2 to 3 physicians.  “One reason for the increased cost is new requirements related to the adoption of EHR’s.”  Nachimson also forecasts a disruption of 2%-6% of claims after 10/1/14.

This is a “crushing burden on physicians” according to AMA president Dr. Ardis Dee Hoven.

Now lean in close y’all, because I really want you to hear this statement without me typing it in all caps.  Pres. Harden:  “Continuing to compel physicians to adopt this new coding structure threatens to disrupt innovations by diverting resources away from areas that are expected to help lower costs and improve quality of care.”

Do you read that the way I do?  What I hear this arrogant puppet saying is that the extra money extorted from physicians should not be, because it was otherwise going to be plowed back into whatever patient-centered-medical-home-texting-skyping-emailing-EHR-HIPPA compliance-culturally-competent-coordinated care crap the likes of her ilk could devise, for our own good.  The statement makes very plain that she thought the $56-$285 K for a small practice would not be going into the doctor’s pocket, which is another way of saying, she didn’t think they really earned it anyway.  Yo, Ardis!  It’s our money!

If Pres.-Dr. Hoven really believes her own statement, then has there been an epiphany?   Where were her complaints about the present system that still causes significant and unnecessary expenses to all health care providers and their patients (not to mention delayed payments, reduced reimbursements, and the ever-present threat of investigations, charges, fines, and sometimes prison)? Where is the quote from this fake admitting that it is wrong for the AMA to profit from government coercion of doctors?

Her banal answer is obviously more politicking, trying to keep an open dialogue with those who will tell us what to do in any event.  She recommends a 2-year implementation for more feedback to physicians.  You’ll still be ripped off, but a little more slowly to spread out the pain.

A real leader would tell CMS, HHS, Congress, and the White House that ICD-10 is wrong because it amounts to stealing from those who actually provide the care.  An AMA worthy of the title would take Doug’s attitude, and Lance’s specific plan, and refuse.  This is exactly a time, and an issue that sellouts like Hoven were not waiting for.  But it has to happen on some day, over some unpleasant issue if we are to ever again win back some of our autonomy and professional self-respect.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Paging Pres. Hoven: The Peasants Would Like A Word by Pat Conrad MD

  1. Sir Lance-a-Lot
    April 6, 2014 at 9:51 am

    Right on, Pat, though I’m beginning to feel like the choir is occupying all the pews.

    There is no force of nature that will now stop me from using the phrase “the Vichy of Medicine.”

    You are going to force me to begin thinking of ways to actually get something like this in motion.

    By the way, my workplace specifically blocks computer access to AuthenticMedicine.
    Coincidence? I think not.

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