This entry was submitted by Keith vom Eigen, MD, PhD, MPH, FACP, who is Chair of the Health and Public Policy Committee for the Connecticut Chapter.
A local pharmacist called recently to tell me that the glucose test strips my patient had been using were no longer covered by her insurance. He couldn’t determine which brand her insurance might cover, and I was unable to find the information on-line. I swallowed hard and resigned myself to the dreaded insurance company phone call. After winding my way through several automated menus, I was finally able to get to a real person — who then transferred me to a different company administering the pharmacy plan. I tried to remain calm as I repeated my, and the patient’s, identifying information multiple times, speaking with four different people. It took half an hour, much of it on hold, to finally get an answer to my simple question. I suppose the insurance company saved a few dollars by shifting the patient to a different glucometer brand, but at what cost to the pharmacist, the patient and the physician? How long will it be before they decide to switch to yet another brand, requiring the same ordeal all over again?
The growing burden of paperwork and regulatory hassle is sapping the joy out of medical practice, especially in Primary Care. Many of us are frustrated by the bureaucracy that limits the time we can spend with patients and that adds little value to patient care. Excessive paperwork and regulation are significantly adding to physician “burn-out.” Of course we need to do something about the rapidly escalating cost of care, but it seems that every cost-saving measure comes with another form to fill out or hoop to jump through. Doctors struggling with the rapid adoption of EHRs often feel more like data entry clerks, and have to scale back their time with patients to manage the information flow and data reporting requirements. And who can figure out, let alone comply with, Medicare and Medicaid regulations?
I was pleased to learn recently that ACP is actually trying to do something about the problem. A new initiative called Patients Before Paperwork aims to “reinvigorate the patient-physician relationship by challenging unnecessary practice burdens.” ACP has developed the program to identify administrative burdens, gather evidence to support advocacy and educational efforts, and assist physicians in implementing mitigation strategies. Through a survey and focus groups, ACP has identified three priority areas to target: EHR Usability, Quality Reporting and Dealing with Insurance Companies. The College is currently working on a policy paper that will outline recommendations to address the problem, as well as a toolkit for ACP Chapters to facilitate discussion and help identify solutions. If you would like to help in the effort, you can send information to ACP (firstname.lastname@example.org) on how the practice burdens you are facing impact your ability to care for patients, as well as solutions that you have developed in your own practice, and how you think ACP can help address the problem. Let’s work together to reduce these burdens to make health care more effective for patients, as well as more meaningful and satisfying for physicians.