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Sunday, August 24, 2014

Political correctness and creative lying

I watched an episode of Girl Meets World with my kids that had Cory Matthews lecturing in class about how you should never tell lies. His daughter Riley was in attendance.  So when he got home and saw that this chicken plate was on the table that didn't look good, he was forced to be honest with his wife.  She kicked him out of the house.

As a Christian, one of the things that bothers me more than anything about healthcare is all the lying we are forced to do.  Allow me to give you some examples and you'll see what I mean.

1.  Clara Patient is an 88 YO lady and her son does not want her to know she has end stage cancer and she's dying. So you go into the room, her son is not in the room, and she says to you: "I know my son knows something he's not telling me. Will you tell me the truth. Am I dying?"

2.  Laboratory regulators insist that all critical values be called to the physician and read back by the physician.  The reality here is that no physician has ever read back a critical value to me, yet I still have to chart it.

3.  CMS declared that we must, in order to get reimbursement, rinse the nebulizer with normal saline after every treatment.  There is no science behind this, it just made sense to some man in a suit who works in Washington.  So a patient says, "Why are you rinsing out that cup?"  Do you lie and say its an antiseptic even though you know it's not?

4.  A patient says, "Why are you giving me a breathing treatment when I'm not even short of breath?"  Do you tell her the truth that the breathing treatment has no effect for her?  Do you tell her that it will help her get rid of her pneumonia?  Or do you tell her the truth that it's so the hospital gets reimbursed for her pneumonia diagnosis?

5.  CMS will only reimburse for a pulmonary function if the ordering doctor writes down a certain diagnosis.  Since they know asthma is one of them, nearly every person getting a pulmonary function test is diagnosed with asthma.  The problem I have with this lie is it screws up asthma statistics, making them look like they are on the rise when they are not. (See 10 reasons asthma rates are still rising)

I know there is a reason some regulations, but they should be made by people who work in healthcare, not people in Washington.  Still, there's going to be times in any job where a little white lie is necessary.  It's just the way it is.  It's what confession is for.  "Father, I have sinned."

The episode of Girl Meets World ended with Cory talking to his children how sometimes it's necessary to tell white lies when it comes to making people happy.

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