Prescribing addictive drugs to boost scores isn't 'unlikely' scenario, and other letters

Regarding the article “Senators concerned docs prescribing addictive drugs to boost survey scores”: Unlikely scenario? This is a totally “likely” scenario that is happening every day. Talk to an emergency department physician. They are pressured into giving narcotics to narcotic addicts to keep their “likeability” scores high. It is never a surprise that the CMS is out of touch with the delivery of medical care.

Dr. James Frost

Regarding the recent article “Complicated, confusing EHRs pose serious patient-safety threats,” the bottom line to any and all IT systems that function within our workplace is that they are a documentation tool. The computer does not replace the human critical-thinking assessment of any and all documentation and directions within said documentation.

The IT system is only as beneficial as the person entering the appropriate data that drives the best-practice warnings or contraindication warnings. We tend to blame the computer, when in fact it is the data that are lacking and/or entered inappropriately.

Scott Kennedy

Regarding the Vital Signs blog post “How much are U.S. doctors worth? Depends who you ask,” figure it out backward. How much should a doctor have at retirement, assuming a conservative investment strategy? Calculate the time available for earning/saving from the age at end of residency to age of retirement and assume a percentage of income saved. Don't forget the Internal Revenue Service.

Considering the time-value of money, and the fact that doctors don't earn any significant money until they are eight years older (or more) than their college classmates, smart people will ask themselves if they should employ their curiosity and intelligence in a more lucrative and comfortable fashion.

Maybe the U.S. should just hire French doctors and the smart American kids will choose careers in insurance and hospital administration.

Dr. Mark Schnitzer

Regarding the article “The flaw in the law: Millions at risk of losing coverage in lawsuit challenging subsidies,” with all due respect, this is what happens when shoddy legislation is used in a rapid cram-down approach by one political group at the expense of dissenters and quality. As to “there is no evidence in the legislative history that the law's drafters intended for the subsidies to be available only through state-run exchanges,” there is no evidence aside from the simple language of the law. Clearly the drafters were looking for ways to coerce states to play ball with the Patient Protection and Affordable Care Act. Recall that the law also had a provision saying that states that refused to play ball would also have their Medicaid dollars cut. The Supreme Court tossed that out.

Obamacare supporters and apologists see this law as a big positive despite all the warts. As such, threats to the law that are inherent in the legislation—be they the simple language or religious rights—should all be sacrificed at the altar of Obamacare. The Supreme Court (and a simple reading of the law) may indicate otherwise.

Dr. Edward Fotsch