You want some cheese with that whine?

Continuing with a recent theme  (re: my April 25th, April 22nd, and April 15th posts).

Is it time to “damn the mandates” and forget meaningful use?
Jennifer Bresnick, April 29, 2014

Even as the healthcare industry marches dutifully into Stage 2 of Meaningful Use, there are still plenty of physicians that have not yet accepted the requirements put forth by CMS in the EHR Incentive Programs.  Dr.  Daniel F. Craviotto Jr., an orthopedic surgeon in Santa Barbara, California, took to the Wall Street Journal this week to protest the restrictive chains of EHR adoption, quality penalties, shrinking Medicare reimbursements, and bureaucratic red tape that prevent a physician from focusing on what’s really important: engaging with and treating patients.

“In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship,” Craviotto writes. “I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it. When do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it anymore?”

Aaron Carroll has a beaut of a response in The Incidental Economist.

Once more unto the breach...
April 29, 2014 at 10:15 am  Aaron Carroll

Austin has been working on his trolling skills. He’s alerted me to another op-ed in the WSJ written by an orthopedic surgeon threatening to walk away from it all.

Look, I’m not suggesting that we limit anyone’s free speech in any way. I’m not suggesting that we shouldn’t hear from unhappy doctors. But I’m going to offer them a bit of (unsolicited) advice. You’re starting to be the docs who cried wolf.

In the interest of providing some media strategy, I’m going to go through this bit by bit. Let’s begin:

In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

OK, right off the bat, you’re claiming that you have no voice in the debate as you are being published in one of the most read op-ed pages in the country. You know who doesn’t have a voice? The 300-plus million people who don’t get to have their thoughts heard in the WSJ...

Ouch. Read the whole thing. An utter smackdown.

Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist?

I’m totally with you here. I think this kind of thing sucks. But do you really think that the average American doesn’t spend a whole lot of time doing things at work that they don’t enjoy? Do you really think lawyers don’t hate billing? Do you really think educators don’t hate teaching to tests and grading essays? Do you really think that small businessmen don’t hate regulations? I think many, if not most Americans, will read this and say, “Wait a minute. You only have to do two hours of crap a day? Lucky ducky!”

Again, read all of it.
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UPDATE

Just in. Relating to the environmental factors of health:

Supreme Court Upholds Air Pollution Regulation

The Supreme Court has given the Environmental Protection Agency an important victory in its effort to reduce power plant pollution that contributes to unhealthy air in neighboring states.

The court's 6-2 decision Tuesday means that a rule adopted by EPA in 2011 to limit emissions from plants in more than two-dozen Midwestern and Southern states can take effect. The pollution drifts into the air above states along the Atlantic Coast and the EPA has struggled to devise a way to control it.

Power companies and several states sued to block the rule from taking effect, and a federal appeals court in Washington agreed with them in 2012.

Justice Ruth Bader Ginsburg wrote the court's majority opinion. Justices Antonin Scalia and Clarence Thomas dissented.

Wow. 6-2. That rarely happens at SCOTUS these days. The smell in the air today is that of climate-denier wingnut hair on fire.

ERRATA

Funny.

COMMONWEALTH FUND INTERACTIVE MAP:
STATES' HEALTH SYSTEM PERFORMANCE

"Interactive." Move your mouse, stylus, or finger around the map for state-by-state data.

DESIGN FLAW

I use the free open source FileZilla FTP upload utility. Very handy. But, twice now I have slipped with my mouse and inadvertently wiped out all of my logins and passwords. Those "clear" items should either be moved elsewhere or backed up with a yes/no "are you sure?" pop-up warning.
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More to come...