The report also refers to the problems of electronic medical records, and of course, it cites outrage over the controversial sustainable growth rate formula (SGR). There are other matters, too, such as physicians evaluating varying definitions of quality, uncertainty over hospital acquisitions, questions about fraud, and RAC audits.
Finally, the Physicians Foundation report discusses "transforming the practice of medicine into the practice of box checking" and "the government coming between me and my patients."
I talked with Lou Goodman, PhD, president of the Physicians Foundation, about the report. Talking about the irritants makes Goodman, an easy-going guy, irritable.
"I think the folks in Washington think they are improving care or making it better or saving dollars, but in individual doctors' offices, there's really no cost effectiveness, no evaluation of regulators and what their impact is," Goodman says. "Let's put some kind of filter on the regulation-writing establishment."
"All these administrative requirements do not have positive impacts on care people are receiving, it seems like we are working at cross purposes," Goodman adds. "We're for progress, but let's make sure it is moving us forward, not backward."
Fred Hyde, MD, JD, MBA, head of Fred Hyde & Associates, in Ridgefield, CT, and a clinical professor of health policy and management at Columbia University, wrote the Physicians Foundation report. He told me that the regulatory evolution in American medicine is evolving from clinical care, where it should be, into misguided oversight of dollars and cents.