I have been elected to serve as the 81st President of the Lee County Medical
Society. I am the second female physician to be president and it is with great pleasure
and honor that I accept this position.
It is hard to imagine that Lee County Medical Society was formed 86 years ago in
1927 with only 11 members. Even then, the need for an organized medical association
was readily apparent. Compare that to today, we have 570 active members and 70
retired members and the need for organized medicine is greater today as we face
issues our predecessors could not imagine.
One of our biggest concerns is how the Affordable Care Act will affect our practices.
For example, the free annual exam promised by the Affordable Care Act puts
physicians in an awkward position with their patients. The free annual exam has its own
specific code that cannot be mixed with another code such as newly reported shortness
of breath. This annual visit covers the exam and “discussion about the status of
previously diagnosed stable conditions.” That’s the exact wording under that code —
insurance will not cover any new ailment under that code. Therefore, the patient will
need to be made aware that they are not financially covered under the free annual
exam if they want to discuss any new or unstable condition. Surely, this will leave the
patient feeling they have been “baited and switched” or leave the physician feeling they
need to provide those extra services for free to avoid committing fraud and to avoid the
angry patient phone calls. Also, patients wanting to discuss new symptoms with their
physician during this free annual exam might find it annoying that the physician is
mandated to redirect the discussion to cover questions such as weight loss, smoking,
seat belts, family life and sexual abuse. This is only one example of uncertainty under
Another physician concern is the uncertainty of whether or when SGR cuts will occur
and how this will impact patient access to care. A large number of Lee County residents
already are uninsured. Those residents who are insured choose plans with lower monthly premiums but high deductibles, leaving them to choose to forgo medically necessary treatments because they cannot afford their out of pocket cost. Many of our physicians have voiced that if the cuts are implemented, they will be forced to not accept any new Medicare patients.
A third issue our physicians are facing is Information Technology. The financial
incentives offered to practices using Electronic Medical Records has been the driving
force behind many doctors switching to this technology. EMR has many positive
features such as prevention of drug interactions or medical ordering errors. However,
many physicians find EMR expensive, cumbersome and time-consuming. One may
argue that the use of EMR actually increases the cost of healthcare as it allows
physicians, at the click of a button, to document a normal comprehensive physical
exam, or review of systems on the record even though these have not been performed.
Of course, these should not be checked off or coded for if not performed; but physicians
are not saints, and they realize that they are reimbursed for what they document and
not necessarily what they perform.
A fourth looming transition will be conversion to ICD-10 in 2014. This system will
expand the number of diagnosis codes from 17,000 to 155,000 and affects both small
and large practices.
Indeed, the need for organized medicine is greater today than it ever was. LCMS’s
Board of Governors will be working hard this year to keep you updated on these
changes and we look forward to your participation and input.
Article provided by Dr Audrey Farahmand – visit her website or call 239-332-2388