Viewpoint FROM THE CHIEF MEDICAL EDITOR

CMS: Paperwork Matters More Than Patient Care

Larry E. Patterson, M.D.

The powers that be in our government don't seem to understand why doctors are hesitant to relinquish further control of our health care system to their oversight. Might I offer a new example showcasing our reluctance?

Like some of you, I practice in a somewhat rural setting. What that means is we got very excited 5 years ago when a Ruby Tuesdays opened up. Back in the good old days, pre-May 18, 2009, patients often drove a long distance to my office because their vision had deteriorated. I would examine them, find that they had developed a posterior capsular opacity, and after informed consent would escort them down to the surgery center where they had YAG laser capsulotomy. Before they arrived home, they were experiencing their second miracle of sight.

Fast forward to today, a month or two later. These same people drive long distances for the same complaints, often with the same diagnosis. But in this draconian post-5/18 period, I cannot help them in the same way. Why? Because in accordance with the new "advance notice" clause of CMS's Conditions for Coverage regulation that went into effect that day, first I must give them a copy of their rights as a patient at my surgery center. They may come back tomorrow and have the surgery, but not today. Never mind the two-hour round trip for which the government doesn't reimburse.

And what vital information is found in this document? They learn that I, their trusted physician, can't mentally or physically abuse them. That they should keep their appointments and notify us if they must cancel. That in an emergency, we will help them. That I won't share their medical records with their next-door neighbor. And that if they have a complaint, they have the right to complain, and to whom specifically they should complain.

My patients have had interesting responses after reading this document, such as, "So this basically says that you guys have to obey the law?" Or my favorite, "There goes 15 minutes of my life I'll never get back."

But the larger problem, besides wasting people's time and money, is that this lengthy new form distracts my patients from the important information they need to prepare for surgery, things like NPO after midnight and the need to take their antibiotic drops. My staff has tried very hard to reduce our cataract pre-op instructions to the very basics, but between the instructions, consent forms and explanation of fees, our patients often get lost in a sea of information. Many of our patients are elderly and are having a difficult enough time just getting the essentials down. Now we've doubled what they have to read because some bureaucrats think they know better than their doctors what patients need.

Washington is finally doing to patients what they've been doing for years to their physicians.