Published in the Orange County Register: June 5, 2014
The only surprise about the tragedy concerning patients dying while waiting in line at our Veterans Affairs hospitals is that anyone would be surprised. I am surprised that no one is addressing the fact that these types of administrative casualties go on daily all across the country.
For years, doctors have been filling out forms and waiting days or weeks to get procedures “authorized.” Patients in obvious distress are “filtered” by way of their primary doctor before they can get to the specialist who might treat them. And now with Obamacare, those wait times are expected to get longer and longer. In January, before the Affordable Care Act kicked in but years into “mass care,” Merritt Hawkins, a physician search firm, published that the average wait time in Boston to see a primary doctor was 66 days, far above the national average of 18.5 days.
The culture of providing care in a bureaucracy is tedious and burdensome. What purpose do the forms fulfill? How do forms further a patient’s care? Those questions have become irrelevant in a culture that is about process and without purpose. We should all be nauseated by these stories.
Health plans and the government reward doctors (with money) for filling out forms. The paperwork has little to do with care and everything to do with government compliance. They (insurers and government bureaucrats) even require that we try a treatment protocol consistent with a government guideline before we can offer the treatment we know will work. How is this any different than the horrific VA story?
The VA failures are representative of what happens when doctors are governed by systems that are more about paperwork than care. The VA story is the story of everyday care in many venues across this country. The medical community should be standing up for our patients and refuse to “play the game.” All patients deserve our professional best.
Marcy Zwelling-Aamot, M.D., is the vice chair of the American Academy of Private Physicians.