And the Shell Game Goes On

So I had this semi-voluntary meeting to attend this week. Some physician-based consulting firm (god I need one of these jobs) hired by the hospital to do battle with the minions that CMS has hired to try to recoup "overpayments" to physicians. The fact that we're even suggesting that Medicare is paying doctors too much is, in my mind, hilarious. Nonetheless, I had to listen to this crap.

Years ago, doctors were under instructions to make "everything" an inpatient admission. Under no circumstances were we supposed to admit someone to observation.

Now, the buttclowns at CMS are in a frenzy trying to ask for money back for admissions that should have only been observation.

As I sat and listened to this physician (mostly only able to think about the fact that the practice of medicine was so painful for this individual that he chose to get his MBA and escape the clinical circus), I wondered if those elected officials in the ivory tower really understand what's going on.

Healthcare will be reformed in some way. And it will almost certainly affect the bottom line of the hospital in ways that mean less vacations to Europe for our administration. Do they not understand that the shellgame is underway? That any effort they make to limit payment to hospitals will result in an entirely new industry devoted to trying to game the new system?

I'm so frustrated with American healthcare that I'm seriously wondering how long I can tolerate this B.S. I just want to take care of sick people. I bring enough value to the table as a hospitalist as-is. I'm going to get very sick and tired of being recruited as a utility in efforts to preserve a hospital's unsustainable profit margin in an era of regulation designed to erode it.