-Caveat Lector-
The "speaker" is "irishdoc," a physician. But, I thought you would all
like to see the arrogance of managed care in action and how irrelevant
the
patient and the clinician become to an HMO.
Marta Russell
Yesterday I was hit with a "surprise" chart audit by your local friendly
HMO.
3 weeks ago they called and said they were coming into audit charts
using HEDIS
criteria so they could get their NCQA approval. We were told what
patients would be
audited and what they expected to be on each chart. (Some surprise) Any
way, I found the reviewer going through parts of the chart that had
nothing to do with this HMO. When I confronted him on this issue, he
informed me that the patient had NO privacy
rights since the contract they singed to get the insurance allowed them
to nose
around where ever they wanted. He was reading a 10 year old operative
report to find out why I had done a hysterectomy on her.
Finally he told me there were 2 options. If the patient didn't like the
intrusion, she could drop her insurance. My option was to forbid him the
chart access he
requested or drop out of the HMO. He also told me that within a few
months, the
information taken from charts by one HMO would soon be on the
internet!!!!! (encrypted he claims). The idea is to be able to share
info with all insurance companies.
He feels the danger of patient info getting out is not important. I told
him doctors
would put a stop to it. He laughed and said Doctors are irrelevant and
are only needed
as a middleman to do the work. Hopefully they would be replaced by
nurses with an
MD supervisor.
He also started to discuss the upcoming DNA mapping on all patients and
the
impact that would have. He said that the HMO's require cholesterol
testing, tetanus
shots, immunizations, PAP smears and next genetic mapping would be
required.
Today I was informed that I would not be able to treat a child with a
hemangioma with a laser until I biopsied it and got the results back.
Are we all going nuts in this world. Guess it depends on what the
meaning of the word "is" is. I want to
win megabucks and move to an island in the Pacific.
>>
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