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    Physicians, patients must unite for major healthcare change

     

    Another feature in this issue, our interview with physician-turned-author Elisabeth Rosenthal, points out not only the value of better patient-physician relationships, but proposes a partnership by both parties to drive actual change in U.S. healthcare. 

    Physicians can—and should—advocate not only for themselves, but also their patients, who are often left bewildered by the process and price of maintaining their wellness. And, as Rosenthal points out, patients should advocate for doctors. 

     

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    The physician-patient relationship has always been important, but now it is critical for caregivers and care-seekers to unite. The task is daunting, because the system needs repair. 

    But rather than sit by passively waiting for the next policy to determine their futures, physicians and patients must make a stand and remind others that they are critical components in healthcare today and should have a seat at the table where decisions affecting both are being made. 

     

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    Keith L. Martin is editorial director of Medical Economics. How are you “Fighting Back”? Tell us at [email protected]

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    • UBM User
      One thing I find particularly ridiculous is the insurance companies right to deny payment for higher level services. Some of the doctors who work for insurance companies are reasonable and approve inpatient stays for patient's who are legitimately sick, while others are just ridiculous. For example, I dealt with a doctor from Aetna Better Health who would not approve an inpatient level of care for a 91 year-old woman with a sodium of 118 who received hypertonic saline and was hospitalized in the ICU. She required 14 BMP's and also presented with small bilateral pleural effusions and an elevated BNP - a harbinger of intolerance to hypertonic saline. Fortunately the patient did well and was able to be discharged in 48 hours, but the Aetna physician told me "because you appropriately cared for her and she got better observation services are appropriate". They hide behind Milliman's extreme ridiculosity like it is the doctrine for care when actually it is better used as a tool for case managers to do an initial screen. The whole point of a physician peer to peer review is to be able to offer a high analytical perspective on patient care and risk. If hospitals and doctors do not rid themselves of this plague of burdensome, arbitrary reviews then I am afraid many hospitals will be forced to close their doors. One way physicians and be more proactive is to thoroughly document why the patient is ill and needs the recommended services. We cannot expect to present skeletal notes, incongruent treatment plans, and a disorganized thought process and assume that we will get reimbursed for it. I am not suggesting that you list a differential diagnosis of a 3rd year medical student, but rather offer a succinct analysis of the patient's condition and acuity and need for treatment.

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