Give Specialist Doctors a Break!


As I scrolled toward the end of a consultation report from Cityside Pain Management the other day, I gasped internally. The pain clinic listed all kinds of mandated “quality” items, by number, that they have no chance of knowing.

Nor should they.

Since our EMRs don’t talk to each other, they have no way of knowing whether I ever ordered a bone density or pneumonia shot for my patient. And if they went ahead and did something preventative, how would I find out about it? Don’t assume I have a realistic opportunity to look for the occasional pearl in the massive number of outside computer printouts I get as PDFs in my electronic inbox.

No specialist should be jealous of my task of trying to stay on top of all my patients’ health maintenance. I send my patients to a specialist so they can spend 45-60 minutes on the single problem that is the main focus of their practice. Why would I want them to spend a significant portion of their valuable time on something that very plainly is my job?

The answer to my rhetorical question is:

Because CMS, the powerful agency behind Medicare, says so – that’s why. It makes no sense to me, but I’m just a country doctor, what do I know?

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


CONDITIONS, Chapter 1: An Old, New Diagnosis

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