Government helped create shift to outpatient care but is suspicious of it

LETTER — Posted June 27, 2005

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Regarding "CMS reports spike in Medicare spending on physician services" (Article, April 18):

Now that we have been coerced and encouraged to discharge patients earlier from hospitals and to provide complex outpatient antibiotics, etc., we are now being questioned and investigated regarding these increases of outpatient expenditures.

In our hospital, as in most hospitals, nonessential work-up is saved for the outpatient setting. In today's age where hospital costs and utilization are being ratcheted, the care of these patients has now been shifted to the outpatient setting. Why is this surprising?

I question whether anybody in the government or the insurance industry has any idea of what they are asking physicians to do. I find it completely ludicrous that we are now being investigated for increasing outpatient visits and minor procedures because we no longer provide them in the hospitals. Clearly, this should have been anticipated.

Leo R. Murskyj, MD, Warren, Mich.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/06/27/edlt0627.htm.

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