I suppose online communication could be viewed as relatively new. I guess email has been in general use since the mid-1990s, and the internet really got going around 10 years ago.

Doctors have been communicating with patients via telephone since when? – the 1940’s . That isn’t even close to new.

So I suggest that this demonstrates how absurd CMS’ approach (now driven by the RUC) to paying generalist physicians is. That it took, what? – 60+ years to even consider whether physicians’ time on the phone taking care of or in support of patients ought to be paid is just ridiculous.

Cindy Hughes, CPC

Fam Pract Manag. 2008;15(1):16-18,21. ©2008 American Academy of Family Physicians
Posted 03/13/2008

Introduction
This year’s CPT update won’t dramatically affect the way you code the services you provide in face-to-face visits. However, it does recognize new ways of delivering health care services. The addition of codes for telephone and online evaluations reflect a reality anticipated in the Future of Family Medicine report – one in which “interactions will not be limited to traditional, individual, face-to-face encounters between the patient and the family physician.”[1] Time will tell whether health insurers share this same vision; at press time, it was unclear whether any of the major plans would provide reimbursement for the services these codes represent.

A table summarizing these and other changes most likely to affect family physicians is available at http://www.aafp.org/fpm/20080100/cptchanges2008.pdf.

She said by her contract with the insurance company, she wasn’t allowed to do that. She quit being a doctor not long after that, the third doctor I’ve had in a row who quit practicing after expressing frustration with insurance rules.

On the other hand, I’ve started asking medical people what they personally would do about routine screening examinations, annual tests, and so on. Mostly they say they don’t bother with that stuff. And statistically they’re no worse off, I gather.

I once talked with a pathologist at some length and he told me that one conclusion he’d come to after years of work is that he always avoids elective surgery of any sort.

I’m starting to agree.

@Larry, universal coverage would be fine by me. It’s single payer I’m afraid of. The govt is already the biggest culprit re: soul-destroying paperwork and ticky-tack regulations that create more work without more pay. But my worst fear is that under single payer we as docs could be pressured (even more than we are now) to put the interests of “society” ahead of our patients’ interests. At least right now nobody is leaning on me to euthanize my sick elderly patients to save money and calling it “end of life care.”