What's in a (Blog) Name?

I’m elated to have been chosen to add my comments to the HCPLive.com blogs. I hope to contribute frequently, be of interest, and create dialogue amongst readers. I tried to come up with a clever title, something catchy that would cry out to be read... but had second thoughts about Lube Job (get it? Lubin?). I was perusing the ICD-9 code book with my office manager trying to find the code for uterine fibroid (not as easy as you would suspect, since it’s under “benign neoplasms”), when I came across an “E” code section. These include accidents in the work place. I forget the number, but one was “being sucked into an aircraft.” I’m not sure I would EVER have to see a patient and code that for reimbursement. So I searched the section, ever thankful that it was still ICD-9 and not the soon to be ICD-10 with 10 times as many codes.

And then I came across my blog title. There, at the end of section E876, was E876.9....”unspecified misadventure during medical care.” I mean, could it be any more appropriate than that? Just about every day there are misadventures in my office, and I’ve been stockpiling them to share with you. I also hope to have some good things to write about, some of the gratifying stuff that can only occur between doctor and patient. I know I will.

Right now, the latest misadventure is Congress’ failure to repeal the SGR (Sustained Growth Rate formula) which will reduce Medicare reimbursement to physicians by 21%. Every year, Congress fails to repeal it and then right before the first of the year, it gets killed. This year is different thanks to Jim Bunning (now Senator from Kentucky), whom I used to follow when he pitched for my then favorite Detroit Tigers in the ‘50s and ‘60s. His vote managed to keep the 21% in effect, that is, until the Senate finagled an extension until the end of March, with an anticipated extension until later this year.

I feel that it will eventually get repealed. There have been local rallies around Florida and town hall meetings have been planned to discuss the problem. But I fear that approach will only be viewed by the public as a means to protect our income. With increasing overhead and overall decreased reimbursements, doctors who see a high percentage of Medicare patients will not be able to keep their offices open. The Internet is replete with stories of doctors who are ALREADY closing up their offices and going to work for larger groups or hospitals. The leaders of the AMA and state societies have been lobbying Congress and attempting to inform them that if the SGR isn’t permanently repealed, Medicare patients’ access to doctors will be severely limited. I’m confident they will be successful, and for our patients’ sake, they better be.