Uncertainty isn’t good for health, and it isn’t good for healthcare

The Pediatric Insider

© 2014 Roy Benaroch, MD

Doctor: “Phil, you have pneumonia.”

Phil: “Oh noes. What shall I do?”

Doctor: “Just take these red pills, here.”

Phil: “Great! I feel better already! When can I go back to work?”

Doctor: “I think in about 2 weeks. Or maybe 2 months. And actually, don’t take those red pills— these blue ones are better. It could take a few years for you to get better, and I’ll be retired by then. Here, have some yellow pills.”

Phil: “What? For pneumonia? I think I’m feeling sick again.”

Doctor: “I didn’t say pneumonia. Have some purple pills. And I have to refer you to a specialist, and get an x-ray. Or an ultrasound. That’ll take six weeks to schedule, or maybe you can do it tomorrow.”

What’s worse than being sick? Not knowing what’s wrong, or how to fix it, or when you’ll get well. It’s when everyone disagrees on what your problem is, and when you get different advice, and when the recommendations change. It’s when what your doctor says doesn’t make sense, and makes even less sense when he keeps changing his mind.

Remind you of what’s going on with the US Healthcare system?

We’re in the middle of the implementation of a huge change in healthcare delivery, based on a byzantine law that no one seems to understand. Unexpected provisions and complications seem to crop up daily. The law is just too complicated for anyone to know what’s that’s in there.

The complexity of the law isn’t the only problem. Not only are new rules and provisions continuing to creep above ground into the light, but established, simple rules seem to change daily. Deadlines? We don’t need no stinkin’ deadlines. While some of the changes seem fair, the uncertainty itself is making it impossible for businesses, patients, and health care providers to prepare. We can’t offer good care if we don’t know what to expect.

There’s even more uncertainty. Congress’s addiction to short-term fixes instead of responsible lawmaking has kicked in again, as they’ve just passed another one year “doc fix” for Medicare payments. They’re also about to delay implementation of a whole new coding system for health care delivery called “ICD-10”—just as thousands of hospitals and clinics have already spent millions preparing for that nightmare. And some states seem hell-bent on implementing unworkable technology “solutions”, in some cases as a requirement to hold a medical license.

It’s a tough time to be a doctor, and a tougher time to be a patient. I don’t think anyone can predict the next complication, and I don’t think anyone knows how to address the uncertainties and shortcomings of what’s coming down the road. My best advice: try not to get sick until we figure out what we’re doing. It’s going to be a long wait.

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