Doctors as bureaucrats

Dr. Crippen continues to post occasionally about the proliferation of requests for forms to be filled out…I admire his ability to actually say no to some of these requests…the most recently one requesting medical clearance for bungee jumping…

Unfortunately, I used to take this form duty for granted, but now it grates (thanks Dr. C!).  When we adopted an EMR, we thought, "Great…now we’ll just print out the school physical and we’ll be all set!"

Nope…the schools have now demanded that whatever crazy form they use MUST be filled out by hand by the doctor!  And they often ARE crazy forms that have information requests that the schools could never possibly rationally justify but require anyway because someone’s too lazy to actually look into why the information is needed.

This issue was crowned today by a woman who presents because her work requires her to have a physician’s note to allow her to use her sick leave.  She had a cold today, felt achy and miserable, and wanted to stay home.  She has more than enough sick leave to accomodate this need.  If she called and told me this, the best I could do is write her a note that says "Yep…the patient called and told me she’s sick.  So I think she should stay home just as long as she wants."  That won’t work for anyone involved, so I have to see her for a cold. 

And, of course, I see her and tell her it’s a cold (which she knew), that only symptomatic treatment (which she can buy OTC) is indicated (which she also knew).  I wrote her a note (which she knew she needed to take her sick leave).  I asked her at the end of the visit if her work pays for her medical insurance that they then require her to use for sick leave she’s already entitled to…"Yes," she says, "It’s all kind of crazy."

As Dr. Crippen might say…Indeed.