Paper Travail

I'm experiencing the reality of something I read in a Time magazine article a long time ago. Something in the article was so profound that it resonated with me then on a personal level and it's resonating with me now on a professional level... years later. Usually when I read something that truly impresses me, I want to save it. I tear it out of the magazine or save the magazine or copy the article. But in this case I didn't and I regret it because the gnawing feeling is bugging me.

Today, with the patient chatter in the front office particularly subdued, I search for the Time magazine archive website and search...and search. What key words should I use? I try this and that and this again. I concentrate on staying calm as I maneuver through thousands of articles. I focus. And low and behold, Eureka! I find it!

It's the cover story, "10 Ways to Cure the Health Care Mess", from the November 25, 1991 issue by Janice Castro.

Here's the quote I'm looking for: "The U.S. has more than 1,500 different health-insurance programs, each one with its own marketing department, complex forms and regulations. Doctors, nurses and clerks are buried in the paperwork needed to keep track of whom to bill for every aspirin tablet. It's a massive waste of time. U.S. health-care providers will spend as much as $90 billion this year on record keeping, according to a Harvard study."

And that was written nearly 17 years ago!

Today, amidst the ever increasing absurdity of having to keep track of every single patient's individual insurance company (of which I count 60 companies among our records) and specific plan (of which there are too many to count), which by the way the patient frequently changes from year to year, (and we have to keep track of that too or we don't get paid) or if they're on Medicare, to bill to Medicare first and then bill again to their supplemental insurance plan (if they have one) and bill to each private insurance company separately, and recognizing that when we do eventually get paid, a sizable chunk of it will go to the billing company who slogs through this mess for us, and don't forget we must also keep track of each patient's network of specialists when trying to refer because they don't have a clue how to navigate the system themselves (how could they?) and, oh, keeping track of that plan's medication formulary because Plan A doesn't cover this drug or that drug and requires a physician's letter to document the justification, and while your fighting that battle with the insurance company and they're stone-walling you as long as possible, the patient dies and then the issue goes away on it's own...

Stop the insanity! Yes, Janice Castro articulated the situation perfectly, "It all is a massive waste of time." And the waste has grown exponentially since 1991.

What have we created? A health care system that forces our doctors to spend a substantial portion of their 24-hour day coping with a bungling administrative quagmire constructed by a billion dollar profit-focused insurance industry instead of allowing them to spend most of their time, attention, energies, and advanced education on what is important - practicing medicine.

Oh, and by the way, many of our best and brightest minds are opting out of medicine altogether because they can no longer stand dealing with this "Health Care Mess".

It's shameful.