Automatic if Doctor and Patient are totally in chargeby admin on 04/03/2018 5:19 AM
There are many forces dealing with controlling health care costs. All efforts have failed. In fact, most of these efforts have increased health care costs and also eliminated essential care. This has caused a decrease in the Quality of Care (QOC), the purported reason for policing doctors and hospitals. Controlling health care costs from the top down is a policing effort. The Electronic Medical Record (EMR) has facilitated this policing effort.
A retired Kaiser physician confided in me that he always felt as if he was working in a glass cage. Every medical history, physical examination, laboratory evaluation, procedures ordered and obtained, and prescription drugs order are available to whoever has access to the EMR. The EMR has been expanded to the Electronic Health Record (EHR) which also records items that the physician may not have ordered but were obtained by the patient through protocol. These may include immunizations, nursing orders, standing orders, or pharmacy orders that may have been administratively changed via pharmacy committee dictate.
In my hospital there was a nurse on each nursing station who reported to the administration and insurance carrier on any item in the medical record that varied from the usual or standard utilization procedures.
At an insurance gathering, one administrator confided in me that he thought they could eliminate the vast army of reviewers and still contain costs. However, he stated that no insurance company would give up this oversight of the profession. Unfortunately physicians are unable to ascertain this as a mechanism of control or how to confront it. The answer, however, is rather straight forward, but not easily obtainable.
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