A new dance: The doctor’s view

Regulation and law handcuffs on relationships and needs: About how your annual physical exam will require a new dance to a new song as single payer government regulated healthcare becomes dominant. It’s all about that ‘free stuff’ some expect to get.

“If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.”

Dr. Peter Weiss explains A Physician’s New Reality: Patients Ask Me to Break the Law. The core issues are those of mistrust and cost. The mistrust shows up in the careful description of what a doctor can do and can not do as well as in how it is billed and managed.

“we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code — insurance will not cover any new ailment under that code.

If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.”

The problem is a common one in business. Management exists to control things in order to be sure that the proper things get done in the proper way so that costs are controlled. The problem is that such control can become the focus rather than the purpose of the business. When the business loses its focus on why it exists, it fails. Since government does not have failure as an option, it has little to divert its attention from process and back to product. That is what is happening in health care.