tag:blogger.com,1999:blog-7772182113499451603.post2706097681700311533..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: The Documentation FallacyGeorge Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-7772182113499451603.post-73665203112730388562017-04-04T16:12:10.745-05:002017-04-04T16:12:10.745-05:00I see the group of "physician-executives"...I see the group of "physician-executives" as being the biggest cheerleaders. How can they not be. I posted some critical organizations under Supplementary 3 that have their boards stacked with physician administrators and managed care administrators. Thy are responsible for some of the quality documentation posted on the APA web site. The professional organizations have a choice about whether they cooperate with it or not. The major discontinuity there is what the physician executives and administrators in these organizations do relative to what the membership on the front lines wants to do. That APA has already demonstrated they prefer the status quo in favor of MOC based on a voting technicality. George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-85769705268546957192017-04-04T16:04:33.779-05:002017-04-04T16:04:33.779-05:00The group of highly trained professionals allowing...The group of highly trained professionals allowing it and cheering it on is not the group being victimized by it.<br /><br />This is the same reason academic psychiatrists have fallen in love with Collabo-care. They don't deal with the consequences of their bad ideasJames O'Brien, M.D.https://www.blogger.com/profile/14994350319492582321noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-57300457483747447972017-04-04T10:07:33.189-05:002017-04-04T10:07:33.189-05:00James - you are right of course by "too littl...James - you are right of course by "too little too late." I forgot to add a link that if followed to the end will show the APA's role in all of this. an extensive document was taken down about how psychiatrists should be quite willing to start documenting meaningless qualities measures to avoid a 1.5% payment penalty (what other profession is penalized out of the box for this type of administrative nonsense). The APA now has links on their wed site to all of the measures that you or I could document to be compliant. These links replace a 35 pages document that used to be there describing all of the quality measures per diagnosis. <br /><br />It is quite unbelievable at several levels - not the least of which is that a group of highly trained professionals allows themselves to be treated like this.<br /><br />I will include the link in Supplement 2.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-34367760300617227352017-04-03T17:40:32.457-05:002017-04-03T17:40:32.457-05:00The ACP is too little and too late and in 2009 the...The ACP is too little and too late and in 2009 they were gung-ho about the ACA and all the crony EHR (Judith Faulkner) that came along with it. Took them eight years to address the problem even though it was already bad by 2009. AAPS has been on this the whole time.<br /><br />These medical organizations are largely headed by academics who don't have to deal with EHR on a daily basis.<br />James O'Brien, M.D.https://www.blogger.com/profile/14994350319492582321noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-62578067997247119972017-04-03T17:23:57.324-05:002017-04-03T17:23:57.324-05:00My job involves extensive forensic chart review, w...My job involves extensive forensic chart review, with the goal of trying to figure out what is actually going on with the patient. I'd figure about one in ten behavioral health notes have any meaningful content. Mostly it is a bunch of placeholder content, boilerplate risk management checklists that do little to actually assess risk, symptom severity scales, and copy-pasted text from months or even years prior. It is a rare treat to actually find a reasoned assessment of diagnosis and clinical formulation. I believe we spend too much time "checking the boxes" in the note, and therefore have too little time to actually think about what we are writing. Anonymousnoreply@blogger.com