Medical Acronym Battles

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In another attempt to make life for physicians as confusing as possible, CMS has out-acronymed itself.   Are you ready?  Here are the highlights of an article that I beg you to try and decipher.  The DaVinci Code has nothing on this:

  • CMS Opens CPC+ to More Primary Care Practices
  • As many as 1,500 primary care practices will have the opportunity for dual participation in the new Comprehensive Primary Care Plus (CPC+) payment model and the Medicare Shared Savings Program (MSSP).
  • The Centers for Medicare & Medicaid Services on Friday, May 27 released an updated fact sheet after receiving “feedback from a variety of stakeholders expressing interest in the dual participation of primary care practices in both an ACO and in CPC+.”
  • CMS officials believe dual participation in CPC+ and an MSSP ACO “may enhance the coordination of care for Medicare beneficiaries and help to achieve our aims of better care, smarter spending, and healthier people,” according to a statement accompanying the fact sheet
  • For practices in Track 2 of CPC+, there will be a payment impact in the Medicare Physician Fee Schedule. These practices will shift a portion of Medicare fee-for-service (FFS) payments for “evaluation and management” into Comprehensive Primary Care Payments (CPCPs), an accounting move designed to reduce FFS payments while boosting comprehensiveness of care.
  • According to the revised fact sheet, “The CPCP and reduced FFS payments together will be calculated based on an amount 10% larger than historical billings to support increased comprehensiveness of care.”

What the hell did I just read?

 

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] 

  7 comments for “Medical Acronym Battles

  1. John Kelly, MD
    June 11, 2016 at 2:35 pm

    Last time I went for Summer CME staffed by U of Michigan docs, I was again disappointed that it was still not about teaching us, certainly not giving us PowerPoint notes on a fancy U of M imprinted thumb drive that we could learn from reading, for fear that we’d go home and make their presentations to our colleagues. So rather than good presentations, we get the important points in jargon orally, so that we might not get it down on notes and learn what the presenters know. And what’s the best way to not teach? Acronyms! The anointed learned educators aren’t there to dilute their advantage in being consultants! They know what the acronyms they spout and put on the PowerPoint screen mean, don’t you? Well, your knowledge is certainly less than theirs. Let’s move on, doctor! There’s more jargon to spout at you. I would be surprised if many come away from most presentations with additional knowledge, but you do have a spiffy thumb drive. Acronyms are in my medical e-mail, everybody putting the titles of their message in acronyms. I have to open the message to find out what the subject actually is, often must open the heading in the e-mail body and read into the paragraph to find out that, of course! CAP is Community Acquired Pneumonia! There are some in wide use, such as HPV and COPD, but NSCLC, PA, AS, and a myriad of others? Seems either lazy not to spell them out, or avoiding letting your colleagues in on the secret before they read your newsletter. It’s certainly not about communicating best you can. It’s the challenge of the anointed.

    • Dr Dave
      June 11, 2016 at 3:20 pm

      John
      On top of the cloak and dagger of holding the various acronyms close to the vest we also have to deal with EVERY portion of healthcare being specifically categorized. Someone can’t have “Juvenile Diabetes” they have to have Diabetes Type 1 or 2 or a class #3 heart murmur. Why we do this is anyone’s guess I think somehow if we are numbering/segmentizing then we can talk amongst ourselves and keep others out including our patients. Sort of like our parents used to spell to us when we were little or in some of our cases (my parents were from Eastern Europe so their parents spoke fluent Yiddish as well as German) the folks would speak in Yiddish and never give us the magic code to decipher things so the language is now lost.
      The biggest issue is when the Magic Acronyms are duplicitous. Like ADA for example means WAY different depending on who you speak to
      It could be the:
      American Dental Association
      American Diabetes Association
      American with Disabilities Act
      It is also a title as in Assistant District Attorney.
      So in our attempt to make things efficient and non-ambiguous as well as professional and direct we have actually made things totally mixed up requiring the reader or listener to stop and ask themselves or the author/speaker what the hell they mean by the letters which of course begs the question why not simply say it out loud to begin with!!!!!?????
      Dr D

  2. Dr Dave
    June 5, 2016 at 5:40 pm

    “If you can’t battle them brilliance then baffle them with bulls**t”

    Pretty amazing how they are trying to suggest that any of these poorly designed nonsensical programs will ultimately render us “properly compensated” for the effort, time, and experience as well as results we generate every day of our careers.

    If they were to only be required to come under the same types of scrutiny and observance in their “jobs” as they put us under the whole concern over medical costs would disappear.
    Dr D

  3. Steve O
    June 5, 2016 at 2:00 pm

    The truth is simple and plain. It takes skill, practice and dedication to become a liar. Especially a liar who believes his own lies. It takes the lubrication of acronyms, jargon and airy thinking to make for a solid lie. And all across America, lying is a growth industry, a boom market, a financial windfall.

    Who is Fred Kinnan? He said, “I know what I’m talking about. That’s because I never went to college.”
    “Stop kidding yourself,” said Kinnan. “The country? If there aren’t any principles any more… if there aren’t any rules to this game and it’s only a question of who robs whom — then I’ve got more votes than the bunch of you, there are more workers than employers, and don’t you forget it, boys!
    Only I’m not going to say that I’m working for the welfare of my public, because I know I’m not. I know that I’m delivering the poor bastards into slavery, and that’s all there is to it. And they know it, too. But they know that I’ll have to throw them a crumb once in a while, if I want to keep my racket, while with the rest of you they wouldn’t have a chance in hell. So that’s why, if they’ve got to be under a whip, they’d rather I held it, not you — you drooling, tear-jerking, mealy-mouthed bastards of the public welfare!”

    Who is Dr. Thomas Hendricks? He said, :”I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.” :

    Every religion that sets out to lie, creates its own words, its own jargon and aphorisms, its own symbols and a’s. Hitler’s thinkers created words from the first syllable of a string of words – NaZi, GeStaPo, etc. It’s a clever method to create synthetic words; Orwell recognized it. We could state “CPC+ and an MSSP ACO” as comprica and a medshasap accaro. It doesn’t matter what sort of soft poison phrases we generate to manage the underlying lie.

    There are very few people who, like Fred Kinnan, who are honest enough to openly lie. That’s why the jargon, the acronyms, the bureaucratese, the Amtssprache.

  4. Pat
    June 5, 2016 at 10:41 am

    We’re short of money in this broken program, and we’re going to keep moving it around so we can pay you less while claiming to pay you more.

  5. DrPhil
    June 5, 2016 at 8:41 am

    Too many TLAs* and ETLAs**

    * Three Letter Acronyms
    * Extended TLAs

  6. DrWally
    June 5, 2016 at 8:29 am

    This BS from BO and his fellow SOB’s is again FOS and should be DOA. CMS is NUTS. WTF?

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