Viewpoint

Impositions on our finite time

FROM THE CHIEF MEDICAL EDITOR

Larry E. Patterson, MD

Because our country has a serious prescription drug problem, especially involving the abuse of narcotic pain medications, my state, Tennessee (and perhaps your state as well) has mandated an extra two hours of CME every two years for all state practitioners with an active DEA number.

And, because somebody decided a few years ago that doctors just don’t have enough to do, recertification, another mandate, became the way of our land.

The latest possible governmental intrusion into our lives is the CMS-proposed postoperative data collection edict.

Hold on: Did I write into our lives? Strike that. Into our patients’ lives. Because every professional activity I’m forced to engage in that doesn’t directly help my patients indirectly hurts them. This includes every wasted stroke on government mandated EHRs and every unnecessary seminar.

I will parse this out, offense by offense.

True, patients are abusing narcotics in record numbers. But are ophthalmologists writing those scripts? How many times did you write a script for demerol or oxycodone this year? Me, I prescribe very few controlled substances and that’s usually a very limited amount with no refills on a post-surgical patient. So physician education sounds like a good idea until you think about it for a nanosecond.

I always thought that it was only a few physicians who were guilty of this — turns out I am right. A newspaper in Pennsylvania wrote an article recently on this very thing, and the DEA is quoted as saying this: “only a small number of them [doctors] are violating the controlled substances act.”

But I still had to attend a two-hour seminar over an hour’s drive away. Add in the time I spent to register and plan for the seminar, it took about five hours of my life. In the end, I learned nothing that would benefit me or my patients.

Other bad ideas

One of the worst offenders is the maintenance of certification exams. While I’m grandfathered from this monumental unproven disaster, I watch my ever-so-slightly younger colleagues expend massive amounts of time, money and travel to meet these new requirements.

The latest offense is the CMS-proposed postoperative data collection edict, something that will distract most of us even further. Not only is CMS violating the requirements of the recent MACRA legislation, it is overburdening those of us who perform surgery with reporting all postoperative services on a claim form using “G-codes.” To make things worse, there is no real guarantee that this will even measure what the regulators think they want!

So when you talk to your legislators about these constantly growing regulations, including MACRA, start calling them what they are: rules that hurt our patients. We all have 24 hours in a day. The more of those we spend doing things that don’t help our patients, the fewer we have left to help them. OM