Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!americast-post Newsgroups: americast.twt.metro From: americast-post@AmeriCast.Com Organization: American Cybercasting Approved: americast-post@AmeriCast.com Subject: Red tape ties up doctors Date: Mon, 16 Nov 92 17:03:26 EST Message-ID: \SE B;METROPOLITAN \HD Red tape ties up doctors \SH New regulations delay test results \BY Arlo Wagner \CR THE WASHINGTON TIMES The "blood-borne pathogen standard" was written mainly to counteract the spread of AIDS and HIV infection through organisms carried in the blood, but for Dr. Cheryl Winchell the federal regulation was the last straw. The Gaithersburg physician closed the small laboratory in her office that had allowed her to quickly diagnose the more routine ailments of her patients. "Although I know this will result in delays in obtaining results and will inconvenience patients, I simply cannot afford the additional costs necessary to meet all the proficiency testing and supervisory fees necessitated by this 'improvement' in health care," Dr. Winchell wrote of her decision. Now, she sends various tests, mainly blood tests, to large certified laboratories or hospitals for examination and analysis. Patients must wait a day or two for the results before she can prescribe treatment. "It's an inconvenience to patients. We don't have the results for 24 hours," said a Chevy Chase doctor, who asked that his name not be published. Before the new regulations, doctors could do simple tests in their offices and have the results right away, he said. The new standard is the latest in a torrent of regulations that most doctors say they agree with in principle, but that are forcing them to keep voluminous records, submit to inspections, sometimes hire extra employees - all of which takes time and adds costs, ultimately to patients' bills. "Some of those things are well founded. Some are just crazy," said Dr. Peter B. Sherer, a hematologist in Montgomery County who said regulations sometimes require medics to "dress up like Darth Vader whenever you see a patient." Not all the regulations falling on doctors, dentists and labs are medical. The alphabet soup of restrictions and agencies includes not only HHS and CLIA - the Health and Human Services Department and Clinical Laboratory Improvement Amendments - but business regulations under the Americans with Disabilities Act (ADA), the Occupational Safety and Health Administration (OSHA) and the Federal Trade Commission (FTC), among others. "It's definitely driving doctors to find other jobs," said Dr. Carol Wilson Garvey, president of the 1,400-member Montgomery County Medical Society. "Doctors feel they aren't being allowed to practice medicine because they are so overwhelmed with administrative aspects." "It's unfortunate they feel that way," said William Grabau of the Maryland Health Compliance Services. Doctors would be grateful for the regulations if they are sued and can prove through records that they followed all safety precautions, he said. Besides, the latest regulations apply not only to the medical profession but to all industries in Maryland where employees may be exposed to blood and other body fluids, Mr. Grabau said. Although Medicare apparently began the regulatory trend in 1965, it was only this year that regulations seemed to become an avalanche, physicians said. In January, for example, doctors began referring to two 4-inch-thick books of codes for diagnoses and services for Medicare patients. The Chevy Chase doctor said some physicians refuse to take Medicare patients and some "don't see patients at [age] 64 because of the paperwork involved." They must now keep records of employees for 30 years after those persons have left their employ. If they have a laboratory, they must keep detailed records, including the room temperature. A technician must sign daily records of routine procedures done by nontechnical personnel. Beginning in September, doctors had to have CLIA certificates if they did certain lab work, like blood testing, in their offices. Certification, inspection and other requirements cost physicians with small practices $550 or more annually. "We are also required to have an extremely detailed lab manual which documents who washes the counter tops each night and what position a patient is in when blood is drawn," Dr. Garvey said. New OSHA regulations also took effect this year, requiring doctors' staffs to be trained and immunized against hepatitis B. And the FTC got into the act recently. "I can't go next door and talk to the doctor about prices and fees. That's an implied conspiracy to fix prices," Dr. Garvey said. She said medical employers nationwide will spend an estimated $821 million to comply with the latest regulations, an annual cost of $1,179 per office. This article is copyright 1992 The Washington Times. Redistribution to other sites is not permitted except by arrangement with American Cybercasting Corporation. For more information, send-email to usa@AmeriCast.COM