Thursday, March 25, 2010

Why Docs Don’t Talk

Did you ever wonder why your doctor is so tight-lipped, saying only the minimum to get through the visit?

The answer is in one of the provisions in Obama’s health care reform that was knocked out: doctors want extra money to talk.

It isn’t said in so many words. But that’s what the proposal to pay doctors to discuss difficult issues with patients was about (the one that gave rise to the ridiculous notion of ‘death panels’).

In an eye-opening interview today on Democracy Now, Dr. Diane Meier, a palliative care specialist, revealed that “it takes time” to discuss options with patients facing a serious illness, and that’s why there was a provision in the health care bill for doctors to be able to bill the time they spend talking to patients.

A propos, during this year of arguing over health care, no one ever mentioned the fact that doctors and hospitals tell patients that the fees they charge are those “allowed by the government”. In other words, everything they do is coded, with a corresponding fee. Why does the government - or whatever organization sets these codes and fees - accept that they be so absurdly high?

Recently I consulted an orthopedic surgeon in a major Philadelphia hospital, who didn’t introduce himself, didn’t explain what he was seeing on my x-ray and MRI, said I could have a cortisone shot or arthroscopic surgery for my torn meniscus, gave me the shot as I requested and charged me $400 - until I protested that I had specifically called in advance to be informed of the cost I would incur for the visit.

People need to do that more often.

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