The PMD Critical List: Many Doctors Are Clueless About Medical Costs

Since office staffs process medical bills and reimbursements, many physicians don’t know how much patients are paying for treatments and medications. That story tops this week’s PMD Critical List. Also making the list: The founder of the Texas Heart Institute passed away, mouth cancer diagnoses are often delayed due to dentist referrals, and burnout prevention tips for seasoned doctors.

• Many Physicians Unsure of Medical Costs (Albany Herald)

A worthwhile report about medicine American style: “The conventional wisdom is that many doctors are clueless about medical costs. That’s largely true because lots of doctors never see the bills and reimbursement transactions that are processed by their office staffs,” says a seasoned family doctor.

• When Doctors First Do Harm (The New York Times)

“Buried in a trove of documents released last summer is the revelation that CIA physicians played a central role in designing the agency’s post-Sept. 11 torture program,” according to this physician-law professor. “It’s urgent that American medicine sends a powerful, public message that there can be no place for its participation in the engineering of cruelty.”

• Doctors Parking Only! (News.com.au)

“The nation’s sickest patients and their families are paying up to 32 times more to park at public hospitals than the high-earning doctors who work there,” according to this peculiar news report from Australia. “I concede it fails to pass the fairness test,” says the president of the Australian Medical Association.

• Physicians in “Unique Position” to Fight Fat (AAFP.org)

“Obesity is at epidemic levels in the US, and family physicians are in a unique position to put a dent in the disease” according to the American Academy of Family Physicians. The doctor group is “challenging” its 125,000 members “to take five minutes to learn more about obesity and how to best engage with patients to discuss their weight.”

• Dr. Denton Cooley, Famed Heart Surgeon, RIP (Houston Chronicle)

A thoughtful and thorough obit by his hometown newspaper about a great American doctor, Denton Cooley, MD, who died at age 96. The “legendary founder of the Texas Heart Institute and arguably the most gifted heart surgeon of his time,” was still going into the office the week of his death.

• Where Marijuana Is the Doctor’s Orders, Will Insurers Pay? (The New York Times)

The matter is now getting “high” attention: “For businesses and insurers, a string of ballot victories this month for marijuana advocates are adding to an intensifying conundrum about the drug and issues such as insurance coverage, employee drug testing and workplace safety.”

• Dentist Referrals Could Delay Cancer Diagnosis (Express)

“People with suspected mouth cancer are having their diagnosis delayed because they are first referred to a dentist, British surgeons have warned. Writing in the British Journal of Oral and Maxillofacial Surgery, the doctors believe “around one in nine patients could have their diagnosis delayed due to the current guidance.”

• Burnout Prevention Strategies for Seasoned Doctors (AMA)

Insightful profile from the nation’s most famous doctor group about a senior physician, who says to his medical contemporaries: “This phase of our life can be the sunrise, or it can be the sunset. It’s kind of up to us. Make it a sunrise.” Tips include: Part-time practice, learning to say “no,” staying fit, hanging around younger people.

• Hospital-Owned Physician Practices: A Win-Win or Lose-Lose? (Dotmed.com)

“Ideally these deals will be mutually beneficial, but that’s not always the case. It’s crucial for both physicians and hospital leadership to understand the potential pros and cons on both sides of these deals to increase the likelihood of success.” Here are some things to watch for.

• Doctors in Full Panic About New MACRA Rule (MedCityNews)

“Even if they don't know it yet, physician practices are going to be scrambling in the next 14 months, thanks to the phase-in of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) regulations. The problem is, half of US physicians have never heard of MACRA.”