Breaking News
March 19, 2018 - AcelRx Announces Receipt of Type A FDA Meeting Minutes and Plans to Resubmit the DSUVIA New Drug Application in Q2 2018
March 19, 2018 - Eye Docs Adopt EHRs Despite Reservations
March 19, 2018 - CRISPR enhances cancer immunotherapy
March 19, 2018 - Study finds first evidence of delayed aging among Americans
March 19, 2018 - Essential oils linked to abnormal breast development in boys
March 19, 2018 - ‘Tummy Tuck’ Relieved Postpartum Back Pain/Incontinence
March 19, 2018 - New biomarkers for neuroblastoma, a type of cancer in children
March 19, 2018 - Hookah Smoking Carries a Poisoning Risk
March 19, 2018 - Do Mood and Anxiety Affect MS Disability?
March 19, 2018 - Mean depth of ultrasonographic penetration greater in autism
March 19, 2018 - Platypus milk may help combat antibiotic resistance
March 19, 2018 - U.S. IDE study of THERMOCOOL SMARTTOUCH SF Catheter completes patient enrollment
March 18, 2018 - E-cigarette use exposes adolescents to potentially cancer-causing chemicals
March 18, 2018 - GOP Senator: Solve Opioid Crisis Through Community, Not Policy
March 18, 2018 - Why is ADHD more common in boys than girls?
March 18, 2018 - Measles alert after two passengers with the disease fly into US
March 18, 2018 - FDA looks to remove nicotine from cigarettes
March 18, 2018 - FDA moves to cut nicotine in cigarettes, helping smokers kick habit
March 18, 2018 - Athenex Announces Phase II Clinical Study Results for KX2-391 Ointment for the Treatment of Actinic Keratosis
March 18, 2018 - Surgery Tied to Better Outcomes in Kids with T2D
March 18, 2018 - Scientists use nanotechnology to detect molecular biomarker for osteoarthritis
March 18, 2018 - Research establishes use of chimeric cells as potential therapy for Duchenne muscular dystrophy
March 18, 2018 - Researcher working to develop improved endoscopic probe for colonoscopies
March 18, 2018 - Researchers develop way to sequence entire fetal genome by modifying prenatal testing method
March 18, 2018 - FDA Approves PDUFA Fee Waiver for Gimoti New Drug Application
March 18, 2018 - P2Y12 Tx Subsidy Yields Positive Response from Docs, Patients
March 18, 2018 - Are Proteins in Formula Linked to Type 1 Diabetes?
March 18, 2018 - Exercise does not seem to increase bone marrow edema in healthy people
March 18, 2018 - Researchers delineate architecture of nuclear pore complex in yeast cells
March 18, 2018 - ‘It’s Just Ghetto-izing People’: What We Heard This Week
March 18, 2018 - Alzheimer’s disease: Neuronal loss very limited
March 18, 2018 - Study reveals impact of intense, changing work schedules experienced by medical interns
March 18, 2018 - Jobs That Keep the Mind Sharp … Even Into Retirement
March 18, 2018 - Facial Scarring Improved with Botulinum Toxin
March 18, 2018 - Data detectives shift suspicions in Alzheimer’s to inside villain
March 18, 2018 - Shorter Preventive TB Tx Effective for HIV+ Patients
March 18, 2018 - New technique for identifying alcoholism puts treatment options at patients’ and providers’ fingertips
March 18, 2018 - Researchers uncover four microRNAs as potential biomarkers for atrial fibrillation
March 18, 2018 - IRX Therapeutics Announces Initiation of Phase 2 Clinical Trial of IRX-2 in Squamous Cervical or Vulvar Intraepithelial Neoplasia 3
March 18, 2018 - OncoBreak: Learning from Silence; ‘Rigged’ Drug System; NCCN Guidelines Questioned
March 18, 2018 - The coffee cannabis connection
March 18, 2018 - Novel centrifugal-flow pump for heart failure patients provides improved long-term outcomes
March 18, 2018 - U.S. FDA Accepts New Drug Application for Prucalopride (SHP555) for Chronic Idiopathic Constipation
March 18, 2018 - Cath Lab Recap: iFR vs FFR $$; Ridaforolimus-Eluting Stent
March 18, 2018 - Tree care workers need better training to handle dangers on the job, study finds
March 18, 2018 - Dementia patients do not undergo diagnostic evaluation at onset of disease, study finds
March 18, 2018 - Transplanting enhanced interneurons restores brain rhythms in mouse model of Alzheimer’s
March 18, 2018 - Gene Therapy Flops for Critical Limb Ischemia
March 17, 2018 - Study spotlights risks in anesthesiologist handoffs
March 17, 2018 - Verb fluency test may be useful tool for differential diagnosis of cognitive failure
March 17, 2018 - Health Tip: Suggestions to Improve Your Cholesterol
March 17, 2018 - Fructans Suspect in Non-Celiac Gluten Sensitivity
March 17, 2018 - Aspirin therapy appears safe before thyroid surgery
March 17, 2018 - Minimally invasive surgical device may one day provide lasting heart repair
March 17, 2018 - UIH and RaySearch enter into new partnership
March 17, 2018 - Is BMI Too Inexact? | Medpage Today
March 17, 2018 - Sleep apnea study finds male-female differences in cerebral cortex thickness, symptoms
March 17, 2018 - Leicester research could help identify people with asthma of different severities
March 17, 2018 - Biosense Webster enrolls and treats first AF patient in clinical study of new RF balloon catheter
March 17, 2018 - Participants in rogue herpes vaccine research take legal action
March 17, 2018 - Imara Doses First Patient in Phase 2a Clinical Trial of IMR-687 for Sickle Cell Disease
March 17, 2018 - AAP: Prevent Medication Errors by Improving Processes
March 17, 2018 - Severe sleep apnea during REM sleep tied to acute CV events
March 17, 2018 - Alzheimer’s disease also affects small blood vessels
March 17, 2018 - Jazz Pharmaceuticals Announces FDA Acceptance of NDA for Solriamfetol (JZP-110) for Excessive Sleepiness Associated with Narcolepsy or Obstructive Sleep Apnea
March 17, 2018 - Switching Biologics in Psoriasis Care
March 17, 2018 - Polygenic risk score may identify alzheimer’s risk in younger populations
March 17, 2018 - Genetic heart mutations account for fewer sudden and unexplained infant deaths
March 17, 2018 - Clinical trial to test efficacy of stem cell transplants in stopping ALS muscle deterioration
March 17, 2018 - Researchers team up to improve life for children with microcephaly
March 17, 2018 - Health guide for young women regarding labiaplasty
March 17, 2018 - Inhaled Nitrite Flops as HFpEF Therapy
March 17, 2018 - California mental health tax providing services to needy in L.A. County, study finds
March 17, 2018 - Cancer survivors become fatigued more quickly than their peers, study finds
March 17, 2018 - Study finds common presence of nightmares among U.S. military personnel
March 17, 2018 - Yellow fever outbreak in Brazil necessitates vaccination for travelers
March 17, 2018 - Health Tip: Waist Size May Help Predict Heart Attack
March 17, 2018 - Low-Dose Combo Pill Successfully Takes Down High BP
March 17, 2018 - Most children with sickle cell anemia not receiving key medication to stay healthy
March 17, 2018 - YCC launches new Yale Center for Immuno-Oncology
Do You Really Need My Signature on That?

Do You Really Need My Signature on That?

image_pdfDownload PDFimage_print

Just sign here.

How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.”

If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring.

The other day I was asked to hand-write the date on a prescription and then initial that I had dated the prescription, despite the fact that it already had the date stamped electronically as well as my own signature in ink.

I understand there are lots of regulations out there, things that have been put in place to prevent non-medical mischief, and we would all be fools if we thought fraud and waste wasn’t happening, if we all just went on faith that everyone in the healthcare system was really only looking out for the best for our patients.

The very concept that me signing something somehow makes it valid tells me we’ve created a system that is really just making sure that in case someone gets audited, that someone has a piece of paper that says Dr. Pelzman said it was okay to do what they did.

There’s my patient who sees a subspecialist every month, but every time the patient and his family present this doctor with paperwork for home care and medical supplies related to the underlying condition they are caring for, they say, “You really need an appointment with your primary care provider.”

Paperwork. About the only time subspecialists are anxious to get patients into primary care.

For that patient, for whom we’re providing no ongoing care given their advanced debilitating condition, we would be happy to engage in their care. But right now they just show up in our practice to get home care forms completed in the hope that by signing pieces of paper and faxing them back to durable medical equipment companies, that will get them the supplies they need to safely be cared for at home.

Are our signatures magical? Once you are a subspecialist, is it that you cannot be bothered with this kind of work?

I’m definitely not opposed to these patients getting the care they need nor the supplies they need, nor should the patient and their family have to go through all this nonsense simply to get what’s best for them.

As long as we’re rebuilding the system to make it more patient-centered, and to make it easier for us to get patients the care they need, while simultaneously improving the lives of those trying to deliver this care, maybe we can scrap all this paperwork.

Put the patient at the center, and let everyone working with them agree what needs to be done. Build this functionality into an electronic system, let the orders flow into our electronic health record and quickly flow out.

Who got to decide that in a state where paper prescriptions for medications are illegal that electronic prescriptions for durable medical equipment are illegal?

How come I can quickly and easily electronically prescribe every medication under the sun, but to give someone incontinence supplies, urinary catheters, wheelchair repair, or wound care supplies, I have to dig out my prescription paper, print a hard copy, then hand-write on the ICD-10 code and fax this off to the equipment supplier?

I want my patient to get physical therapy — I suggested it; I put in a referral to a physical therapist — but once they decided what they wanted the patient to do, why do they need to send them back to me so I can sign a piece of paper that says I think it’s okay that they get the things done that I thought I wanted them to do?

Why, when I send my diabetic patient to podiatrist, do they need to send a piece of paper to me that says I’m treating the patient for their diabetes and that they can give them diabetic care and diabetic footwear?

If I evaluate my patient and detect a hearing deficit, and I then refer them to an audiologist, who does the testing they do and determines that this patient needs hearing aids, why should they need to send me a piece of paper to sign that says I say it’s okay for them to have a hearing aid?

We’ve built up too many regulations, and we’ve allowed too many people who don’t know how to take care of people to get in the way of taking care of people.

I’m sure somewhere there are a bunch of regulations that were written with good intent, but too many people have misinterpreted them, used them to their advantage, and twisted them to try and make their own lives easier, when all this does is interfere with the care we’re trying to give our patients.

I really don’t think that even the federal government really needs me to hand-write today’s date on electronic prescription that has the date printed on it by the computer, and then initial that I dated the dated prescription. We’re drowning in a sea of paperwork, and we’ve gotten to the point where all we want to do is just sign on the dotted line.

We need to change the system to create a place where we can take care of our patients, where fraud cannot flourish, but so many of these rules and regulations need to be peeled back, to fall away, to free us up to be able to once again deliver truly patient-centered care.

Show me where to sign.


Tagged with:

About author

Related Articles