[goodtimesintv]

Originally Posted by golfing eagles

Sadly, you are 100% on the mark and I have seen everything you describe and more. But I'm just going to comment on the two statements that irk me the most:

I hate the phrase "That's not my patient" I trained in "the old days" when you helped out your fellow resident, stayed until all the work was done, even if it ended up being 40 straight hours. There was no such thing as "not my patient". We were all there BECAUSE of the patient, not in spite of him. Even if a nurse was overtaxed, she would help with a patient or immediately get someone who could. Somewhere in the 90's this all changed, as nursing focus shifted from patient care to documentation. It was the exceptional nurse that could do both (I'm glad you could). The problem was that a nurse was more likely to get "in trouble" for not documenting volumes of paper than for taking 30 minutes to answer a call bell---we can thank the regulators for that one. I remember the first time, in 1999, that I heard a young physician state "that's not my patient", He was 25 years old when I sat him down, I have no idea how old he was when I finished lecturing him. In my opinion this was a result of the "shift mentality" that arose in the aftermath of the Libby Zion case that changed the nature of physician training nationwide.
As far as the example you gave goes, it is almost unbelievable. I cannot imagine something like that happening. In the reverse situation, the first line, the VERY FIRST line of that encounter would look something like "Pt returns from winter in Florida with newly diagnosed T1N0M0 ER+PR+ ductal carcinoma of the R breast. A 1 cm suspicious lesion was discovered on routine mammography; she subsequently underwent stereotactic biopsy with positive pathology. Pt elected to undergo lumpectomy with axillary node dissection and completed 6 weeks adjuvant RT, now on arimidex" I just can't see writing anything else---but this didn't happen not once, but twice? And your "boss" didn't think anything of it??? If Karma exists, this is what will happen down the roda---the patient will call concerned that she has a recurrence of her breast cancer, and the physiciam will respond "What breast cancer?"---Good luck with what ensues then.

This is just the modern version of writing volumes by hand. We actually have a pediatrician in town who uses a desktop instead of a laptop, so his back was constantly to the patient/mother!! But the reason for all this computer time falls squarely on the government regulators and insurers. We are being used as glorified data gatherers for God knows what reason, and their hunger for this data grows exponentially. Now, they have no idea what the data is or what it means or how it relates to patient care---they are just there to "gather" it. Very efficient, huh? [COLOR="rgb(255, 0, 255)"] I am so glad I retired a few months before the implementation of ICDM 10---7 digit "codes" for each diagnosis, with thousands of pages of government regulation behind it. So you can expect more computer time and less patient time from your next visit.[/COLOR] Not to be political, but consider this---If you can't get the people to want socialized medicine, and you can't get the doctors or Congress to approve, then[COLOR="rgb(255, 0, 255)"] just regulate the industry until it crumbles leaving no choice.[/COLOR] If you don't think that can happen, I have two words to say---"coal industry"

That's right. Wreck it so that people are desperate enough to want anything promised them by the bureaucrats.

From "The 16 Most Absurd ICD-10 Codes" being inflicted upon medical clinicians:

5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter​.

How does this happen? Are water skis even flammable?

4. W55.29XA: Other contact with cow, subsequent encounter.

"Other contact with cow." OTHER CONTACT WITH COW? There are codes for "bitten by cow" and "kicked by cow." What else is there?! What, precisely, is the contact with the cow that has necessitated a hospital visit?!

3. W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela.

The existence of this type of code does not engender trust in the National Aeronautics and Space Administration. Shouldn't they have more control over their spacecraft than that? Or are they just careening around in the ether, pinging into one another and injuring occupants/astronauts?

2. W61.12XA: Struck by macaw, initial encounter. ......

See the whole story:

The 16 most absurd ICD-10 codes | Healthcare Dive

Do people have ANY idea what is going on with these bureaucrats??????