Insurance Companies Impede Ability of Physicians to Care for Patients

Insurance carriers are incapable of defining and measuring quality, and their attempts to do so degrade the care physicians are able to provide, according to this author

The Lund Report, March 21, 2016
by Dr. Mike Henderson

OPINION -- The healthcare system is failing patients and physicians. In a recent article, a 46 year old woman initially presented with shoulder pain, and according to her lawyer, eventually had a heart attack, possibly requiring a future heart transplant. This article isn’t about the merit of this particular lawsuit or tort reform in general. I am an internal medicine physician and see the larger issue of a system failure, and such examples are inevitable. Physicians are set up to fail with resulting patient harm. The reason for this article is to delineate the basic flaws. Understanding how they interrelate answers the questions of how and why the system is failing.

Quality care demands continuity of care, but continuity is too frequently broken. The patient mentioned above presented with typical symptoms for a common, benign condition, yet that incident was the needle in the haystack. She then saw multiple providers.

Current documentation is more about data entry for the purposes of research, avoidance of malpractice and billing than for the purported goal of documenting care, compounding the negative effects of the lack of continuity of care. Each provider no doubt tediously entered a note into an electronic health record. Should physicians concentrate on the patient or clicking boxes? One can’t be done without compromising the other. Electronic records sound great, but they are a distraction, producing generic, template driven notes for subsequent providers to use. The patient is reduced to a pattern of checkboxes and nonsensical pull down statements. The patient’s meaningful narrative is lost. This improves billing, but is terrible for documenting clinical analysis.