LMS Newsletter, March 2018 article
Tuyen T. Tran, MD, MBA
Thank you to all of our physicians who attended the Physicians’ Day at the Capitol. Many of our state legislators commented on the numerous white coats at the Capitol. Similarly, at the AMA National Advocacy Conference, many members of Congress also commented on how much they appreciated seeing physicians there to advocate. So, I think we, physicians, have successfully communicated to legislators at the state and national level that we want to participate in reforming our dysfunctional medical system. Now, I challenge you to help formulate talking points to optimize our chances of being heard by our legislators.
To effect meaningful change, we must first unite. We must encourage the leaders of our specialty societies to work with KMA and AMA to represent all physicians. Next, we must courageously and honestly examine and expose the etiologies of our broken medical system and advocate to our legislators for changes to improve the practice of medicine. We need to advocate that the ultimate purpose should always be better care for patients. Facilitating health care delivery processes for physicians should be equally prioritized because it directly impacts patient care. Physicians want to spend time with their patients, examine their patients, and deliberate on the differential diagnoses and treatment options – provide medical care. Physicians should not waste time documenting irrelevant pieces of information to satisfy a billing code, persuading an insurance representative that his/her patient needs a certain procedure or medication, or justifying medical necessity for rendered services.
Physicians should not have to practice in a climate of unsubstantiated regulations and bullying. Government and insurance companies constantly ask us to demonstrate patient outcome measures. Well, I believe we should pose the same question back to these entities. If they can demonstrate that these regulations and prior authorizations improve care for patients, we will comply.
At both the state and national level, many of the legislators that I visited requested that physicians send them specific regulatory and insurance mandates which hinder physicians from practicing good medicine. I worry about the Merit Based Incentive Payments System (MIPS). It promises reimbursement bonuses if the physician’s score is above the median. But since the system is obligatorily budget neutral, the curved scoring system implies that some of the physicians will receive a reduction in reimbursement. I predict that the system will divide physicians and preclude collaborative sharing of best practices. I am skeptical that MIPS will lead to better patient care.
I am certain that you have specific issues which hinder your ability to practice good medicine. Please send the LMS (LMS email) your top concern (offer a solution if appropriate) and explain how it negatively impacts patient care. We will aggregate the issues and submit them to our state and national legislators. With concise talking points and a unified voice, we have a much better chance at persuading our legislators to listen.