MCMS Physician Fall 2017 - 4

mon t m e d s o c .c om
mon t m e d s o c .c om

Editor's
Editor's Comments
Comments

Politics Blur Lines
Between Fact and Fiction

Letter from the Editor

The world is upside-down.
As I sit here, Sunday, the
19th of February, it's 69 degrees
When Two
is enough
"enough"?
outside.
of my kids
are
running
around
the
front
yard in a
I've been asking that question
long
pants
and
short
sleeves.
Our
lot lately. As the summer of 2017
newest addition, Maxwell Jacob,
wanes, a lot of the news in the
is napping in the stroller wearing
world is bad. Hurricane Irma is
late-spring clothes. Just shy of
wreaking havoc, while North Korea
five weeks old, he knows nothing
threatens
nuclear world,
destruction.
about
the outside
and that's
Down
in
Boca,
one
of
my
oldest
fine with me. He'll learn soon
friends
is
in
a
panic,
rushing
to
enough.
packWhen
up her Ihouse
kids
before
the massive storm
Despite
stare and
down
into
his liquid-brown
eyes,hits.
watching
multiple
to help,
there's littlebetween
I or hertwo
other
friends can do
the
binkyoffers
bounce
up-and-down
rapidly-growing
cheeks,
I can't
but wonder
what
kind of America
will
(especially
fromhelp
up here
in Pa.). It's
depressing
- indeed,he
almost
come
of ageInin.these
We situations,
are at a crossroads,
thistonation
ours,
infuriating.
it's hard not
feel a of
sense
of and
ever
since he of
arrived,
found
myself
pondering
what role, if
hopelessness,
despairI've
over
events
beyond
our control.
any, physicians will play in America's future.
But what about the things that are closer to home, that touch
I don't mean professionally, of course. We all know what
our dailydo,
lives
inmy
a more
proximal
way?meant
Whiletodistant
can
doctors
and
comment
wasn't
imply events
that there
still
be
powerful,
they
allow
us
to
shield
ourselves
-
sometimes
would no longer be a use for us. Rather, I'm thinking about
unconsciously
- fromand
their
true
impact.
Webetween
feel empathy
for those
social
responsibility,
the
special
bond
physician
in
harm's
way,
but
there's
always
that
nagging
voice
that
whispers,
and patient. I've written about this theme many times, but like
God it to
isn't
us." Most
of uscoming
try to ignore
voice,
a"Thank
moth drawn
a flame,
I keep
back tothat
it. Especially
now.
pretend as though it doesn't exist. It'' what brings out the best in
We've
all heard
theand
terms
"patient
and "shared
us when
disaster
strikes,
helps
reveal autonomy"
"the better angels
of our
decision-making,"
but at what point does our duty to the truth
nature."
outweigh another human being's thoughts and feelings? Some
But
I digress.
lines,
such
as the long-debunked link between vaccines and
autism,
are
clear. Others,
likeinopinions
basedseveral
on thethings
dreaded
As a physician
practicing
Pennsylvania,
have
'Google
seem
It'smade
easy to
happenedsearch',
this year
thatless
notso.
only
mepoint
angry,out
butinformation
have invoked
which
is blatantly
false - the idea
that
antibiotics
an
the above
sense of helplessness.
While
I have
written are
ad nauseam
effective
treatment
for
viruses
comes
to
mind
-
but
what
about the many challenges doctors now face, it's hard to ignore the
does
oneseem
do when
confronted
with
a worldview
that
holds
any
hits that
to keep
on coming.
And
it brings me
back
to the
viewpoint grounded in science with suspicion, or even disdain?
fundamental question: when is enough, enough?

With all Due Respect: Science Trumps Opinion

I'm talking about politics.
Earlier
year,I proceed
a major insurance
company
in Pennsylvania
Now,this
before
any further,
I'm going
to make it
decided
to
make
a
change
to
what
is
known
as
"Modifier
25." In
clear that I believe conversations about a patient's political
short,
insurer
decreed
for anyonpatient
who underwent
a
views,the
voting
habits,
and that
positions
hot-button
issues
procedure
during
an
office
visit,
any
remaining
evaluation
and
are clearly off-limits and have no place in the exam room.
management
billed the
same dayand
would
be reduced
by 50%.
However, in codes
our current
adversarial
disruptive
era, how
a
patient
may
have aa direct
impact onfor
how
they
In
other views
words,politics
if you are
visiting
rheumatologist
a checkup
perceive
educated
professionals,
andthat
potentially
disrupt
theneeds
of
arthritis,
and he or
she determines
one of your
joints
relationship.
And inforour
political
apatient-physician
steroid injection, the
reimbursement
thecurrent
rest of the
visit is
climate,
nowhere
is
this
more
pronounced
than
women's
automatically cut by half.
health. Charges that physicians routinely perform elective lateSo abortions
why is this(and
a bigare
deal?
Don'tcompensated
doctors makewith
a lot taxpayer
of money?
term
illegally
The
answer
is "it's
complicated."
Reimbursements
for all
services
funds)
or the
erroneous
idea that
birth control pills
promote
have
been
declining
for
years
while
simultaneously,
expenses
have
promiscuity have become a rallying cry for those whom this
soared.
In any
other
business,
prices
up, athe
consumer
particular
social
issue
is near when
and dear.
Asgoboth
physician
and
sees
a hit toI respect
their wallet
but medicine
with
a person,
that-point
of view asis adifferent.
personalBoth
belief,
but
not as theMedicaid
foundation
publicinsurance,
policy. And
recently,must
I've found
Medicare,
andofprivate
physicians
accept
myself
questioning
even
that billing
respect.allowed
(Full disclosure
-I
what
they
are paid, no
balance
(while balance
wouldcan
personally
support
legislation
banningsuch
elective
billing
occur under
certain
circumstances,
as forabortions
outat
20
weeks
or
earlier,
but
only
if
they
contain
exceptions
for
of-network charges, I will not address that particular issue here.
of the
mother,
granted
decision-as
Ithe
amlife
alsoand
nothealth
suggesting
that
patientand
costs
haven'tfinal
skyrocketed
making authority to the patient and her physician).
well, because they certainly have, but that is a topic for a separate
The Pennsylvania Senate has once again introduced
discussion.). Physicians are constantly told "that's the cost of doing
legislation to prohibit the termination of pregnancy beyond
business," yet we are not in business - at least not according to
20 weeks. Despite unified opposition from the American
those
who write
the laws.and
Adjustments
such-asboth
thesenationally
are often
Congress
of Obstetrics
Gynecology
unilateral
decisions,
giving
doctors
little
choice
except
to "take
and the Pennsylvania chapter - the legislation passed
the it or
leave
it."and now it moves to the House. While Gov. Wolf will
Senate
certainly
vetoarethe
should
it make
it to With
his desk,
So where
alllegislation
these supposed
'savings'
going?
billions
the
fact
that
it
is
even
being
debated
begs
the
question:
is the
of dollars in profits and multi-million dollar yearly compensation
outcome preordained? Can we simply guess what type of bills
packages for many of their CEO's, I find it hard to believe that
legislators will introduce based on whether they have a 'D' or
this move was enacted to stem major losses. When queried, the
'R' next to their name? Despite overwhelming evidence that
company in question responded that their decision was designed
a) the majority of abortions performed in the United States
to
help facilitate
a move
"fromand
volume
to value." procedures
That is a are
happen
in the first
trimester
b) later-term

MCMS PHYSICIAN 6 SPRING 2017
MCMS PHYSICIAN 4 FALL 2017
https://www.montmedsoc.com/
Table of Contents for the Digital Edition of MCMS Physician Fall 2017
