Being a person who renders opinion and advice regarding medical billing and coding issues, I have done my level best in this space to remain neutral as the political infighting continues in our nation’s capital with regard to health care reform in general, and physician reimbursement specifically. A glance at the calendar is changing my mind.

Today is February 5th, and being that this is the shortest month of the year (think of February as Tattoo and the calendar as Fantasy Island), I count that there are 23 days left until Medicare will begin instituting a 21.3% pay cut across the board for all physicians. Seeing as a cut of this magnitude immediately places countless medical providers is dire straits, and by extension our clinic-based medical infrastructure in jeopardy, one would think that this issue would be at the top of the list for a country that embraced “promote the general welfare” as a founding ideal of the nation. So it is with surprise that upon looking at the Congressional calendar for February that Congress is giving themselves a break for the entire week beginning February 15th. This drops the actual days to fix the problem to roughly 18, but anyone who has ever tortured themselves watching C-SPAN can tell you, U. S. Congressional work must be judged on quality of time spent, and not quantity.

Physicians are already taking a financial hit in 2010 with the Medicare’s elimination of reimbursement for consultation codes. As specialty organizations urgently lobby their members to contact Congress to issue a fix, Congress is snapping into action by taking 5 days off.

I spend my work days being a physician advocate. While it is not the place in life that I pictured for myself in my childhood, I think of myself as a very important part of our healthcare system as it is currently configured. Physicians spend 10+ years being trained to solve the myriad issues involved with the inner workings of the human body. We don’t contact a physician when we’re feeling great. A doctor is called when something is wrong. I object to this being  referred to as “A God complex” as so many do, as this is not a preordained royal imprimatur, but rather an outcropping of the decade or more of training necessary to understand and positively restore human beings to maximum function. I feel I owe it to a physician to take financial worries off the table and let them concentrate on what they have been trained to do.

I had five doctors in my family ranging across four different medical specialties. I find the scientific healing of the sick to be a fascinating world, not only for what is known about the human body, but what remains unknown as well. Had I been a better student (a FAR better student), it’s very possible that I could have ended up on the clinical side of health care rather than the administrative. As it is, my mind is geared more for appreciation of physicians rather than the occupation itself. Having said that, with the current insurance landscape, the work I and others on this side of the healthcare industry explore through on a daily basis (when exactly this became an “industry” rather than a noble trade, is long forgotten), from tracking down every possible dollar of reimbursement to helping design defensible documentation for medical services, takes on increased importance. None of us should gain any joy from knowing that our doctor is up in the middle of the night not solving the problems of a sick patient, but rather contemplating their financial future.

If you’ve been in this industry for any length of time, you become desensitized to the annual rite of Congress reversing a well-publicized physician payment cut. It is analogous to a long-term hostage-taking, where after a while being chained to an oil heater in a basement, being beaten and tortured and living on bread and water becomes a new standard by which to measure “normal”. If no one else is going to stand up and say it, I will. This latest deadline to end all deadlines isn’t business as usual, and it’s not something we should just get used to and coexist alongside, awaiting the usual temporary solution. It’s sick, it’s depraved and it has to stop.

11:53 pm, February 28th, 2010 |