You have my written testimony and the attached information. In the interest of time I will depart from the written documents. In response to the question…how does this law affect the physician-patient relationship? The answer is…it destroys it.
This has been developing for many years, but this law truly makes it crystal clear. In fact, Dr. Donald Berwick, the former head of CMS has written that for this law to work…”the traditional physician-patient dyad must end.”
All of you on this committee see your doctor from time to time. What do you expect from the visit?
You’d like a friendly compassionate doctor who will listen to you, examine you and talk to you. The doctor will call on extensive training and experience to devise a plan that you both agree upon and understand.
Your doctor simply wants to do what their training has prepared them to do…listen to your history, do a physical exam, discuss the findings and recommend a plan.
Unfortunately, that is not how things are going in medicine.
To illustrate how things are changing, I’d like to share some stories.
Electronic medical records systems have been touted as a “cure” for many of the problems in our health care systems today. Unproven and untested, these claims are simply not true.
During a recent sales demonstration at my hospital, the presenter, a physician’s assistant, took 30 minutes to demonstrate how to document the patient encounter with their system. The process was unfriendly to both patients and doctors.
One of our primary care physicians asked…”how do you propose that I do this in the 15 minutes that I normally have with patients?”
He answered….”The goal is to reach at least a level 3 visit.”
I’ll say that again…”The goal is to reach at least a level 3 visit.”
In other words, the billing trumps the medical care.
He added…”So, you have your nurse enter the history data, you fill in the physical exam data, make the plan and move on to the next patient.”
Really? Where in these 15 minutes do you talk to the patient or listen to the patient…you, the doctor?
As a patient, how do you feel? Did you develop a relationship or are you part of an assembly line? I think that most of us know the answer and it should make us both sad and angry.
And then there is this account of a fellow physician’s recent experience taking her father to visit his new primary care doctor:This is her story…
“I took my father, 80 years old and living independently, to meet his new internal medicine physician yesterday.
I sent ahead a brief summary of his history, list of meds, and request that he do a physical exam, since it had been well over three years since it was done.
After introducing himself, he immediately announced that federal 'guidelines' no longer allow regular exams. An exam allows only listening to hearts, lungs, and bowel sounds (with patients sitting, mind you) - and does nothing else unless there was a specific complaint to justify it. I asked if anemia (which my father has) justified a rectal exam - he said no. He of course quoted repeatedly the US Preventive TASK Force recommendations as one of the standards. He recited the statistics and the 'societal' cost arguments. He had it down; a perfectly 'useful idiot'.
He said he only does 'evidenced based' medicine. In fact, he had just been to a conference to confirm the validity of his positions. I did not engage him - it was not appropriate with my poor father sitting there listening to how he is too old for……well, anything.
Eventually, to pacify me, the doctor went through the motions of the rectal exam (after having to leave the exam room to get gloves and lubricant, which are of course, of no use to him). I doubt he even knows how to do a rectal, since my Dad (who has had many) hardly felt it. “
Again, guidelines trump medical care.
This is the reality of Obamacare. There is no care. This law, supported by organized medicine, has been consistently opposed by Docs4PatientCare and AAPS.
Things do not need to be this way. We need not turn our doctors into government drones. But, under a government controlled one-size-fits all plan, that is what we can expect and what we are witnessing nationwide…today.
Physicians are being buried under increasing financial and bureaucratic burdens. Time is literally stolen from direct patient interaction, destroying the physician-patient relationship and fragmenting patient care.
This does not have to occur. American physicians need to be free to do what they have been trained to do…excel at practicing medicine.
American patients need to be free to choose health insurance plans and medical treatments that suit their needs, not something coerced by a central authority. This is simply impossible under the suffocating burden of the Affordable Care Act.
Thank you for the invitation to speak with you today. I’ll be happy to entertain your questions.