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Doctor, listen to me

By Jennie L. Phipps ·
Friday, June 27, 2014
Posted: 1 pm ET

Dr. Michael Wasserman, a physician whose specialty is in geriatrics, is spending his own retirement promoting the notion that doctors -- especially those who treat older patients -- ought to listen better.

Dr. Michael Wasserman, retired geriatrician

Dr. Michael Wasserman, retired geriatrician

"You go to a lot of doctors today. They will look at electronic medical records before talking to the patient. By the time the doctor comes into the examining room, his mind is made up. Doctors see things in electronic records, but they don't corroborate it with patients, even though some of that information may be in error," Wasserman says.

Some doctors are in such a rush because of their perception of what Medicare pays, Wasserman believes.  "A lot of doctors complain that they don't get paid enough by Medicare, so they don't have any choice but to spend as little time as possible with patients. ... If you tell a primary care physician that he could make $200 an hour just seeing seven or eight patients a day, he would look at you like you are crazy," says Wasserman, who is affiliated with the Altarum Institute, a nonprofit with a mission to solve health care policy problems.

What doctors don't understand, he says, is that Medicare will pay up to $200 an hour for an appointment that is spent educating and counseling patients.

To busy to learn the system

The larger problem, Wasserman insists, is that doctors don't know how to use government billing systems -- and they are often unwilling to learn. "We had a grant in Colorado for more than $1 million to teach physicians how to code Medicare bills properly. When we called the offices of doctors, they told us, 'We're too busy and we don't make enough money to learn how to do this right.'"

So what can a patient or a family do if they go to see a physician who doesn't take time to listen?

Start by making sure that your retirement planning documents include advance directives and health care proxies and power of attorneys, so you can choose quality of life over being kept alive to suffer.

Don't be passive, Wasserman advises. Make sure that the physicians caring for you and your loved ones are listening and paying attention. "Patients need to take in a stop sign and hold it up and say, 'Stop! Don't put my square peg in your round hole. I want you to listen to me or to my mom and dad.'"

Wasserman also suggests, "If you have a loved one who is in the hospital, make sure that the health care providers who care for them get to know them as human beings. If you know that a parent is seeing multiple physicians and receiving various treatments, find a way of going along on some of these doctor visits and make sure that the doctor knows your parent's priorities."

Also consider this related topic: Do you really want to settle for Medicaid?

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Rajat Bhatt MD
July 11, 2014 at 8:14 pm

What is the billing code for spending 1 hr counseling patients , I would like to do that

j haupin
July 09, 2014 at 4:56 pm

actually, if you have a loved one in the hospital, particularly if they're on medicare, PLEASE maker user that they are ADMITTED and not being held for observation overnight. it makes a huge difference if they are then sent on to a nursing home or rehab facility. under new rules that went into effect recently,The decision for inpatient hospital admission is a complex medical decision based on your doctor’s judgment and your need for medically necessary hospital care. An inpatient admission is generally appropriate when you’re expected to need 2 or more midnights of medically necessary hospital care, but your doctor must order such admission and the hospital must formally admit you in order for you to become an inpatient. If subsequently transferred to another facility Medicare may foot part of the bill. If you're an outpatient, and if transferred to another facility, you foot the bill, not Medicare.