Monday, November 10, 2008
Doctors are not smart. We all know that. They don't know what medications to order for their patients. That is why Pharmacy Benefit Managers were created. They tell doctors which medications are better to prescribe. Those same medications are cheaper for the insurance companies, but that is a coincidence. Fortunately, the news about physician stupidity has been spreading. Health insurance companies used to block orders for CT scans and MRIs from doctors by using their own staff. I guess that was too strenuous for them so now a new entity has been born. Radiology Benefit Managers have taken the lessons from PBMs and are making doctors get permission to order some awfully expensive but life saving tests. So what if the delay of a certain procedure causes risk to the patient? That is the doctor's fault for losing control of the healthcare system. In fact, he or she can't even blame the insurer or RBM in a malpractice case. No, doctors lost that battle as well.
Before physicians out there fret too much, they need to realize that every rejection by a RBM can be remedied with an appeal, hours and hours of paperwork, and lots of their staff's time. Ahhhh....there is nothing like the feeling of being rejected by a third party bounty hunter who has never even seen the patient they are rejecting! Will physicians wise up and band together to stop these RBMs? Are you kidding? If doctors were smarter they would have all walked away from managed care years ago.