Doctoring General Medicine Health Care Health Care Reform

A maze of 5 digit numbers and a cure for the upcoming doctor shortage…

One of my new tasks in joining a new practice is learning CPT codes for what I do.  Said differently, I am learning how to bill for services rendered.  Never needed to this in the past as my large group had an army of business folks (coders) who did this for me.  They of course require a salary and medical benefits.  The new practice is smaller, nimble and rightly takes the position that the doctor should be the best person to do this coding thing.  Although, it seems to be a maze of 5 digit numbers now, it is a finite amount of info that will be mastered soon.

I have learned that the coding rules change frequently and at the whim of the government (CMS or Medicare).  For example, as of Jan 1, 2010, there are no more consult codes.  Bam, just like that the evaluation, examination, synthesis of data and formulation of a plan, using 15 years of post-secondary education is no longer worthy of the term “consultation.”  Sure, we can use other 99*** numbers for the encounter but they pay substantially less. 

Jeez, quit the whining already, have not you already written that cardiologist do ok? Sure, but then I read this…

Congress urged to lift cap on medical student residencies.

Darrell Kirch, president and CEO of the Association of American Medical Colleges, in an op-ed for the Wall Street Journal (1/5), writes that the US has a shortage of doctors and that the situation is likely to get worse. Kirch estimates that the US will have a shortfall of 125,000 doctors within 15 years. Kirch argues that the only way to remedy the situation is for Congress to eliminate a cap on the number of medical students in residency programs that was implemented along with the Balanced Budget Act in 1997.

Here are some smart people espousing that the upcoming doctor shortage will be cured by increasing the cap on the number of medical students.  You think?  Or, might it be the difficulty in convincing a high school senior to spend the next 15 years training to be a sub-specialist whose well being is controlled so whimsically.  My guess is there will be enough doctors for those that can and will pay -like you do for root canals.  For those who depend on Medicare, not so much. 

Already the Mayo Clinic in Arizona is not accepting many Medicare patients.

Think there is no shortage of doctors.  Try calling a highly regarded surgeon or sub-specialist and tell them you are a Medicare patient and need an appointment, “soon.”

Where is the foresight?