Growing number of rigid protocols in medicine


 

I am sure that the trend described in the article will impact the mental health profession soon.

 

http://online.wsj.com/article/SB123914878625199185.html#mod=djemEditorialPage

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3 Responses to “Growing number of rigid protocols in medicine”

  1. Becky Says:

    My understanding is that the government’s oversight will involve the insurance companies and large entities such as hospitals, not the individual practitioners. It would be most definitely wrong for the government to have any say about what your doctor thinks is the best treatment for you. Right now the health insurance companies are often dictating how you will be treated– from which prescription is appropriate for your condition to whether or not certain diagnostic imaging or screening bloodwork might help identify or even PREVENT illness. That is wrong. Is there another source of information about what specific plans are being considered? If so I would like to know about it. I spend many minutes/hours per week fighting insurance companies to get medications and treatments covered for our pediatric patients. Our pediatricians do not frivolously order treatments or tests without medical neccessity, they use generic meds whenever possible, and they leave the majority of the specialized (expensive) diagnostic tests to the specialists when they think they may be neccessary.
    I feel the doctors should be judged by their patients and their peers and that’s about it.
    I’m sick of reading everyone elses opinion in the media and general population. I would like to form my own judgements and opinions based on whatever REAL facts are available to me.
    I found the following information on the ‘whitehouse.gov’ website along with an outline of the administration’s stance on healthcare reform. They are general staements of course and I would love to see some more detailed explanations of what would be implemented:
    “On health care reform, the American people are too often offered two extremes — government-run health care with higher taxes or letting the insurance companies operate without rules. President Obama and Vice President Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.”

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  2. diddly Says:

    If the new paradigm or universal health care will be anything like how Medicare is run, I am worried. I just got audited by Medicare and I am waiting for the results. I will not be paid for those dates of service if I fail. They want to see certain things in my documentation that really don’t reveal anything about the quality of treatment from the patients’ perspective. I diligently track patient outcomes from the patients’ pespectives as a matter of course and this data is of no interest to the Medicare audiotors. Medicare sees therapy as a branch of medicine with diagnosis and symptoms. But anybody who has seen a therapist knows this is usually a small part of what gets attention in therapy. I hope I do better than I expect to based on what they requested.

    I have had fewer problems with the private insurance companies including ritecare. They also do audits but they have never threatened not to pay me for services already rendered, assuming I have prior authorization. I know that the psychiatrists have difficulty getting many meds approved though from private insurances. Medicaid is cracking down too.

    If everyone has health care, and that is certainly a worthy goal, by definition health care resources are going to be scarcer. I can only picture them wanting to have more control of things, not less.

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  3. Becky Says:

    I have little knowledge of Medicare since I dabble very little in the internal medicine department. I do know that they often make no sense (as far as what they cover) from the billing department’s and physician’s perspective. United Healthcare is high on my crappy health insurance list. They have cheaper premiums because they don’t pay squat for services (that they actually cover…).
    The new generic rule does have it’s merits but it really screws the kids on psych meds and stimulants for ADHD. One of our more complicated clients who gets his meds managed by NCCMH was arrested at school for violent and aggressive behavior about 3 weeks into switching from Focalin XR to a generic ‘equivalent’. He is also on Wellbutrin. He is 13 and had no previous arrests. We have to waste lots of time on the phone getting priors for Epi pens (hello?!) because there is no generic autoinjector available. Wah, wah, wah.
    Anyways, I wish they would clean up the giant mess of a welfare system we have. There’s a lot of money wasted there. These moms need to be drug tested regularly and forced to work! They don’t know anything different b/c they are 4th generation welfare familes. It’s ‘normal’ for the girls to get pregnant at 16 just like mommy did. Believe me, the pediatricians work very hard to try and steer these girls (and boys!) in the right direction but it seems like the success stories are few and far between. It’s not right that this lazy portion of the RiteCare community somehow has the money for a new cellphone every other month and cigarettes but they can’t shell out a modest ($5?) copay for their visits and prescriptions. It’s criminal. Seriously, why don’t any of our representatives have the nads to take the real problem on?
    Universal healthcare would need oversight from morethan one entity. There needs to be ‘checks and balances’ so no one group (govt, clinicians, or insurance co.’s) has the ability to control things exclusively. Preventative medicine works and is not emphasized with our current healthcare system. I really hope things change for the good. I wish I could be a more active part of the solution!

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