Letter: Change imposes unrealistic rules

The doctor-patient relationship is the most important part of the medical profession — I’ve learned this in my 28-year medical career. We even swear to put our patients’ needs above our own when we take the Hippocratic Oath.

But our promise is under attack by Obamacare. It includes several new regulations that put barriers between doctors and the sickest patients.

The first involves Medicare’s coding system. Hospital-employed physicians now only have one code and one reimbursement rate for every treatment.

Why is this a big deal? Imagine that you’re an auto mechanic. The law requires you to charge $100 for every service you provide. You have 10 customers who need new brakes and 10 who need engine repairs. But since engine repairs take significantly more time, you can do only one in the time it would take you to do all 10 brake changes.

You have a choice: You can do all 10 brake changes in a day and make $1,000, or you can do one engine repair and make $100. Common sense says you’ll do the brake changes.

Obamacare’s new one-size-fits-all billing system is no different — the customers needing engine repairs are patients needing intensive care. The patients who need the most help get the least help.

Ditto for Obamacare’s re-admission rules. Hospitals are now penalized if they readmit too many patients within 30 days. While this appears to be a good-faith measure of accountability, it ignores the medical reality that every patient requires unique and personalized treatment.

Recent advancements in medicine allow doctors to do much more for seriously ill patients who would have never survived in the past. However, the trade-off is that those patients require more frequent treatment. This is not the fault of doctors or hospitals — it’s what’s required to keep those patients alive.

The Obamacare rule doesn’t make this distinction. Hospitals now have a reason to avoid patients whose conditions require constant care, like those with diabetes, high blood pressure and heart disease. This hurts the elderly and the poor the most.

Under Obamacare, the government wants doctors to follow cookie-cutter rules without regard for our patients’ needs. Yet, our oath requires us to do the opposite. This isn’t the “reform” that politicians like Sen. Mary Landrieu promised us when they voted for Obamacare. For the sake of my patients, perhaps Washington needs to adopt a Hippocratic Oath of its own.

Gerard Gianoli

physician

Covington