Doctor IcedLatte's Bill of Rights.

Here's what I want:

• I want to practice in an environment where I am pleasantly pushed for time but not crazy whackadoodle frantic.
• I want to have enough time to look at your boogers AND ask about your sick mother.
• I want to have enough time in my day so that you can tell me finally something serious that has been bothering you for months but you've felt unable to talk about until today without feeling as though I need to jump off a roof because now I'll be oh, four patients behind.
• I want to spend exactly 15 seconds on bookkeeping for encounters, not 2 minutes looking up ICD-9 codes, 30 seconds documenting for the insurance company nonsensical crap, 30 seconds documenting for the tiny lawyer I imagine is reading over my shoulder.
• I want to document just enough relevant information for any other physician or nurse to be able to pick up the chart and glean, in 10 seconds or less, exactly what they need to know from the appointment in 10 seconds or less.
• I never want to write a chart note again that is comprehensible to a high school graduate who audits my charts for the insurance company. If you don't know what "hematemesis" is, don't touch my damn chart. It is mine.
• I never want to hear from an insurer that even though I spent (and documented) 45 minutes with a patient discussing 210,243 serious problems, reviewing 453 lab values and radiological studies, prescribed 25 medications PER PROBLEM, and stabilized the patient prior to transfer to the ICU that I couldn't charge a 99215 because I forgot to include how many cigarettes the patient smokes a day.
• I don't want patients to look at me sadly and say, "You're the third doctor I've seen in the last few years who's gone out of business."
• I want to have time to sit and think. I want to sit with your damn chart and doodle while I stare at lab values. I want to have time to look things up and make notes. I want to have time to call your cardiologist on the damn phone and I want him or her to be happy as hell to talk to me, shoot the shit for a minute, then discuss your care in longer than 30 seconds of hurried conversation. Then I want him or her to have time to tell me what is up and coming in the treatment of whatever it is you have.
• I want to have time to pee, dammit!
• I want time to come over to your house if you've just had a baby or are too sick to come out, or are dying, or immobile for whatever reason. I want time to call you on the phone and see how you're doing. I want to come and hold your hand and not fret about all the money I'm losing since I'll never ever get paid for the visit and don't even try anymore.
• I never want to hear from a patient again that they didn't get a colonoscopy/pap smear/mammogram/whateverthehell because their HSA doesn't cover it and they don't have $5000 to cover the deductible. Neither do I.
• I NEVER want to hear from a patient again that they're pulling their kids out of sports because mom or dad lost their job and COBRA is going to be $1500 a month and who can afford that and if one of the kids got hurt playing football without insurance who could afford the ER bill? I can't. Food, gas, and a roof or insurance?
• I never want one more damn stupid F*$&ING prior auth from an insurance company for a generic drug. Or anything. You've never ever turned me down EVER so stop wasting my damn time and yours.
• I never, ever, ever again, as long as I am alive, want another letter from an insurance company wondering why so and so hasn't had a flu shot/urine micral or anything else done ever. Because you know what? Either you already paid for it and have such crap computer systems that one hand doesn't know what the other hand has paid for, or the patient said "no" the 50,000 times I've asked. Back off.
• Oh, how I never want to fill out another set of FMLA forms for 2 hours missed at work for gastroenteritis. Next time I am sending the patient in to puke all over your desk. Or worse.
• Speaking of stupid, I never want one of those letters like "Your patient has chosen" (HA! Should say "Was forced nearly at gunpoint") "to take part in Active Health Management of their chronic disease." This means that now I will be getting forms to fill out which I will throw away. You want to pay me to write down every single LDL over the last 5 year? No? Hello, shredder. I will also get calls from a insurance company nurse whom neither the patient nor I have ever met. I am going to be busy every single time you call so don't bother.
• I want my beloved Nexium pens back. Wow, not supplying free pens has brought the price of branded medications FLYING down and changed my prescribing habits so much. Damn. Who knew? Oh wait, the lack of a $0.05 pen hasn't changed a damn thing.
  
• Why the hell does the AMA supply prescribing information to pharmaceutical companies? How is that protecting anybody's interests except their own? Why do I have to opt out of that program? I should have to go to some trouble to opt in, but why would I bother?
• I'd like to not face prison time if accidentally and with no malice aforethought I saved the government money and charged a Medicare patient LESS than I should have.
  

Let me sum up:
I want to take care of sick people. Period. Why is that so difficult?