Regarding Dr. Bruce Wolf's op-ed, "Another way docs can transform lives" (Nov. 25, p. 23), I wholeheartedly agree that most physicians went into medicine to help others, especially the less fortunate, and that this sense of mission can be harnessed to care for those without financial resources. For physicians to render more charity care, however, requires that they have resources to give, be it his or her time, expertise or empowerment, that does not distract from the doctor's need for a balanced life.
The government can help by reducing or eliminating administrative burdens, such as one requiring a physician's or their facility's ICD-9 or ICD-10 coding to be based on provider documentation of exact language prescribed by the classification. If a coder could be given leeway within defined parameters to assign clinically congruent codes without a burdensome documentation and query process, the physician would have more time to devote to indigent or charity care or to accept the lower reimbursements Medicaid offers. Electronic health records must also be made simpler to use, recognizing that today a typical system adds 1-2 hours to a physician's day without any perceived benefit to the physician.
There must be some way of incentivizing physician cost efficiency in light of the current medico-legal climate to make resources more available to the underinsured. Sadly, given the legal community's self-centered interests and political donations that fuel Congress' operations, what incentive does a politician have to reduce the costs of provider accountability? Perhaps there can be a “Good Samaritan” rule for a physician providing charity care in certain environments.
Physicians are human, just like lawyers, politicians, journalists and other professionals. While money and margins are essential to our operations, we do have a mission to do what we do that adds fullness to our lives. I think that Dr. Wolf is onto something.
Dr. James S. Kennedy
CDIMD–Physician ChampionsSmyrna, Tenn.
