Physicians, especially primary care physicians (PCP), often bear the brunt of what many consider to be excessive regulatory requirements associated with patient care. Here are the most common administrative burdens, according to physicians.
Pre Authorization for Medications and Tests
For PCPs, there can be a preauthorization catch 22, because payers often require a specialist order for approval of diagnostic tests, but the consulting specialist often wants to see the test results first, before seeing the patient. Nicole Price Swiner, MD, co-author of Thinking About Quitting Medicine, is a PCP in Durham, North Carolina.
“Paperwork is the bane of my existence,” Swiner says. As a PCP, she says that she is required to fill out requests for insurance companies to authorize everything her patients need, such as medications, procedures and consultations.
Managing Consults From Specialists
PCPs, in particular, experience roadblocks when it comes to obtaining and following up on specialty care for patients. Fabiola Antonelli, MD, an internist in Dallas, Texas, shares her experience with this problem.
“My consults are discontinued and denied multiple times, and I have to sign off on preauthorization templates for Lyrica, Plavix and many other specialist-ordered drugs that my patients need,” Antonelli says.
Doctors across specialties learned in medical school that the patient chart is a valuable record to be used for communication between physicians, nurses and all patient care providers. Dena Hubbard, MD, a pediatrician in Kansas City, says that in her experience, the requirements that need to be met in filling patient charts focuses on criteria that do not center on patient care.
“Charting for billing and coding are based on malpractice prophylaxis rather than communicating the details of patient care from one provider to the next,” Hubbard says.