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So then what does it specify. It's open you tell us
Good flippin' grief.
As several other posters have previously stated, it states that the patient's physician must consult (ie, inform) their 65+ aged patients on all end-of-life healthcare choices IF they have not had such a consultation within 5 years.
What this means, is that the physician, upon looking through the patient's chart and seeing that the last such consult was dated more than 5 years previously, must again provide this information to the patient. They do not have to schedule an appointment per the wording. I take this to mean that they would review the consultation status at each PATIENT-SCHEDULED APPOINTMENT...or possibly telephone the patient.
This is not unlike a physician checking the chart of a child for absence of timely vaccinations, checking the chart of a cancer patient every few years after initial treatment for follow-up care, etc.
The knee-jerk, paranoid reactions to this segment of the bill make no sense to those of us who are actually IN the medical field.
A year before my Mom died we sat down and had a very long talk. She told me that she did not want to become a science experiment to see how long they could keep her alive. She wanted me to make sure these wishes were carried out and went to see an attorney for an Advanced Directive. I was appointed her Health Proxy and given Power of Attorney. Mom even made her own funeral arrangements around the same time. Mom's death went according to HER wishes. I don't think she needed any doctor to "counsel" her.
I am 60 myself now. Maybe my views don't coincide with many of yours, but I feel the same as my Mom. I don't want my life prolonged either to become a science experience, or a vegetable.
My Mom died with DIGNITY; HER view of DIGNITY, not anybody elses.
Your post is very contradictory: you both want to die with dignity, yet you balk at the prospect of a physician providing information about Advance Directives, hospice care, etc.
You are lucky, in that you have previous exposure to this issue. MANY patients--especially the elderly, hence the provision in the bill--do NOT.
There are many abuses made against the elderly in their final years, days, and hours by uninformed family members in the absence of Advance Directives.
As several other posters have previously stated, it states that the patient's physician must consult (ie, inform) their 65+ aged patients on all end-of-life healthcare choices IF they have not had such a consultation within 5 years.
What this means, is that the physician, upon looking through the patient's chart and seeing that the last such consult was dated more than 5 years previously, must again provide this information to the patient. They do not have to schedule an appointment per the wording. I take this to mean that they would review the consultation status at each PATIENT-SCHEDULED APPOINTMENT...or possibly telephone the patient.
This is not unlike a physician checking the chart of a child for absence of timely vaccinations, checking the chart of a cancer patient every few years after initial treatment for follow-up care, etc.
The knee-jerk, paranoid reactions to this segment of the bill make no sense to those of us who are actually IN the medical field.
You "take this to mean" is irrelevant. How do you know that a physician can simply call a patient on the phone to relay this information or that they just need to document this on an unrelated sick visit? You haven't provided any facts aside from your interpretation yet are shouting at everyone as if you know the facts. I'm sorry but I will wait and see what is truly required of physicians before I rely on your word. Also, I'm a physician not a medical billing specialist.
Also, I'm a physician not a medical billing specialist.
Neither am I, dear.
I do the dirty work of trying in vain to read pathetically sparse/contradictory/incompetent documentation by inpatient physicians, informing Risk Management of possible litigious actions, querying in vain those physicians who refuse to provide adequate diagnoses (or clarify obvious mistakes) in terms from this century rather than acronyms of their own design, so that continued patient care is not compromised from poor documentation. I deal daily with physicians, many of whom are doing their best to cover up medical mistakes; ordering clearly unneeded tests, medications, and procedures; and dictating/scribing some of the most insulting and degrading comments about their patients imaginable.
I wouldn't be so proud of your profession. It's one of the biggest reasons we have skyrocketing costs to patients and substandard care in this country.
I do the dirty work of trying in vain to read pathetically sparse/contradictory/incompetent documentation by inpatient physicians, informing Risk Management of possible litigious actions, querying in vain those physicians who refuse to provide adequate diagnoses (or clarify obvious mistakes) in terms from this century rather than acronyms of their own design, so that continued patient care is not compromised from poor documentation. I deal daily with physicians, many of whom are doing their best to cover up medical mistakes; ordering clearly unneeded tests, medications, and procedures; and dictating/scribing some of the most insulting and degrading comments about their patients imaginable.
I wouldn't be so proud of your profession. It's one of the biggest reasons we have skyrocketing costs to patients and substandard care in this country.
Yeah, physicians are such bottom feeders. All they do is save peoples lives and work toward improving patients health. What a bunch of losers. Being a pencil pusher is where it's at. Isn't generalizing fun?
Yeah, physicians are such bottom feeders. All they do is save peoples lives and work toward improving patients health. What a bunch of losers. Being a pencil pusher is where it's at. Isn't generalizing fun?
I see many good physicians and plenty that are just waiting to be sued.
You are extremely naive if you think that every doctor is alike, in it for the lofty values you describe. Many are in it for the big bucks, and rising physician salaries (compared to several decades ago) should clue you into that.
When physicians leave lap sponges inside patients during 'routine' laparoscopic gallbladder surgery, neglect to confirm before/after counts in the OR prior to closure, wait til the patient is septic with failing kidneys to re-open them--TWICE--before finally finding said sponge....and then go so far as to pressure the head of Financial Services (of which coding is affiliated) to pressure me to change the coding and eliminate all complication codes and subsequent surgery codes to cover their a**, then YES. It is very good to be a lowly pencil-pusher.
I raised a stink and had the coding director who pressured me (and attempted to destroy part of the record) fired, and the physician lost all privileges before coming before the state medical association.
The family sued. And won.
I've worked as a consultant in over 28 facilities in 7 states. What I saw at that hospital I've seen repeated in differing degrees in every hospital.
Back to the subject of this thread--why is NOT waiting for a medical emergency before informing patients of their rights and options such a point of contention here?
A year before my Mom died we sat down and had a very long talk. She told me that she did not want to become a science experiment to see how long they could keep her alive. She wanted me to make sure these wishes were carried out and went to see an attorney for an Advanced Directive. I was appointed her Health Proxy and given Power of Attorney. Mom even made her own funeral arrangements around the same time. Mom's death went according to HER wishes. I don't think she needed any doctor to "counsel" her.
I am 60 myself now. Maybe my views don't coincide with many of yours, but I feel the same as my Mom. I don't want my life prolonged either to become a science experience, or a vegetable.
My Mom died with DIGNITY; HER view of DIGNITY, not anybody elses.
I believe under the bill, the services have to be offered. The patient does not have to accept.
I do the dirty work of trying in vain to read pathetically sparse/contradictory/incompetent documentation by inpatient physicians, informing Risk Management of possible litigious actions, querying in vain those physicians who refuse to provide adequate diagnoses (or clarify obvious mistakes) in terms from this century rather than acronyms of their own design, so that continued patient care is not compromised from poor documentation. I deal daily with physicians, many of whom are doing their best to cover up medical mistakes; ordering clearly unneeded tests, medications, and procedures; and dictating/scribing some of the most insulting and degrading comments about their patients imaginable.
I wouldn't be so proud of your profession. It's one of the biggest reasons we have skyrocketing costs to patients and substandard care in this country.
You're a bureaucrat and you expect a bunch of people on a forum that strongly dislikes bureaucrat to take you seriously when you **** on someone who's a physician?
I believe under the bill, the services have to be offered. The patient does not have to accept.
That's what I got out of reading it. It is more a directive to the Practitioner that if they see it has not been discussed in five years, they need to discuss it with the patient. There is nothing forcing the patient to have an Advanced Directive if they choose not to or even listening to the Practitioner.
You're a bureaucrat and you expect a bunch of people on a forum that strongly dislikes bureaucrat to take you seriously when you **** on someone who's a physician?
What, just because he/she is a physician, they're somehow above criticism??? Get a grip.
Quote:
Bureaucrat
n.
An official of a bureaucracy.
An official who is rigidly devoted to the details of administrative procedure.
Government employee who follows a rigid procedure in administering the responsibilities of a position. A classical bureaucrat follows a set of rules and procedures in an impersonal manner. A bureaucrat is a career professional evaluated on the basis of merit and skill.
Official
n.
One who holds an office or position, especially one who acts in a subordinate capacity for an institution such as a corporation or governmental agency.
Based on the above definitions, I'm hard-pressed to see myself any differently than anyone else 'who holds a...position' (no more than this definition in blue, which probably covers a large number of posters on C-D), but definitely not as the classic definition of a 'bureaucrat'.
I hold no official office, nor am I employed in any administrative capacity, for either a healthcare or government entity.
I am, however, employed professionally by several hospitals to abstract information, code, and be on constant lookout for anything amiss: poor medical documentation, accidents/injuries/overdoses, etc. I am there to protect the patient's medical record for accuracy, ensure proper coding so that the patient/insurance company are not overbilled and to also contribute to statistical analysis.
I have to adhere to strict procedures or face termination by the facility I work for, or prosecution by the government. I used to work for a facility after they had been raided by OIG for improper coding (which, interestingly enough, was done on the strict orders of their physicians).
I respect many physicians, as they are professional, courteous, talented, comprehensive, and skilled. Quite a few others have proven themselves to be pompous, untalented, discriminatory, apathetic, close-minded, or incompetent. Strictly on a case-by-case basis.
But--when one of them comes off and tries to insult me because I'm not another physician like they are (I doubt it would have made a difference if I was a nurse, ARNP, or PA), I'm going to let them know exactly how I feel.
And whining because they have to spend a little more time with their patients so they can be informed...sorry, it just galls me.
The other thing that galls me is how so many are in league with Big Pharma and the insurance industry--it's no wonder that we have not seen a comprehensive change in the system. The AMA has rallied against change for a very long time.
I don't believe in doctor worship. Neither should you.
Last edited by rayneinspain; 07-24-2009 at 10:59 PM..
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