Physician blogger Richard Young wrote this provocative guest-post at the popular medical blog KevinMD.com regarding patient-centered care reforms in primary care billing. During a recent conference on primary care research, Young challenged the current evaluation and management (E/M) billing system dictated by Medicare that determines how much documentation doctors must do to justify a charge.
In short, Young argued that a major obstacle to primary care physicians providing patient-centered care is the disincentive to address multiple health issues during a single visit. In short, doctors are giving away their services if they address multiple issues:
The E/M rules are way too complicated, but in a nutshell, after I address two issues with my patient the rest of the visit I’m giving away my services. If you’ve ever visited a primary care physician for your migraines and high blood pressure, then was annoyed that he insisted you make another appointment to talk about a rash that just appeared, now you know why he did that. If he addressed the rash on the first day he was paid nothing; if he addressed the rash on a different day he was paid the full fee.
Young’s full post argues that doctors need less gadgets and gizmos (which was what was being touted at the conference he was attending) and more common sense patient-centered reforms. You can read the full post here and please share your comments below.