When I started my training, medicine was drastically different than it is now. MRIs were brand new. You might be able to see a lesion the size of a golf ball on MRI if you were lucky. Ophthalmologists had just begun using intraocular lens implants and phacoemulsification had not yet been invented. Doctors were very personable and spent time making sure your problems were addressed and treated the best way current medical advances allowed. They faced you when speaking, looked you in the eye, and treated you like family. Office visits were usually billed at 3 levels, small, medium, and large, depending on the work done. There were no billing codes, computers, or EMRs. Doctors billed what was called the “usual and customary charge”. This was whatever the doctors said it was. When advances in medicine occurred and results improved, doctors raised their fees with minimal restrictions. I remember as a pre-med student, shadowing doctors on hospital rounds and listening to their conversations in the doctor’s lounge. The logic was that if everyone got paid the full amount for a procedure, next time charge 10% more and see what happens. Fees escalated until the insurance companies put their collective foot down leading to Health 2.0.
The insurance industry responded with a policy to make doctors “show your work” through evaluation and management codes. This is an elaborate and complex system for justifying the doctor’s charges. Unfortunately, over the years, it has occupied more and more physician time. The bureaucracy has exploded, including managed care, E/M coding, CPT codes, ICD-10, HIPPA, PQRS, HCAHPS, MACRA, MIPS, Press-Ganey, and on and on. Doctors now spend about 50% of their time actually caring for and treating patients and 50% tackling the bureaucracy in an attempt to acquire a reimbursement. Doctors responded by consolidating, forming large “clinics” or “institutes”, and abandoning small private practices. Patients felt like they were on an assembly line. The computer screens became the patient. Instead of talking to a doctor face-to-face, patients got to look at the back of their heads while the doctors asked questions while typing away on the computer. Patient complaints were addressed by providers and hospitals putting up signs about how compassionate and caring they were rather than actually addressing the problem. Physicians became commodities and were no longer called doctor. Instead, we became “providers”. The greatest casualty of Health 2.0 is losing that distinctly human relationship with your physician that elevated medicine from a career to a calling. We lost the heart and soul of medicine along the way.
Vision Care 3.0
This is our effort to bring back what we believe is truly important in medicine. While we at Keszei Vision Care cannot change the system, we can pledge to practice medicine at the highest level possible. Rather than clutter the website with claims of how we are experts or a world-class institution, we let our actions do the talking. We strive to provide the best medical care possible with the latest technology, compassion, heart, and understanding. Please give us a call to set up an exam and experience Vision Care 3.0 for yourself. We would love to hear from you