Care Coordination: Is It A Doctor’s Role?

Today, I read an entry from Merrill Goozner on his Gooznews blog called “AMA:Pay Docs for Care Coordination”.  He writes at the beginning:

“The little-known American Medical Association committee that recommends physician pay scales to Medicare’s fee-for-service program today asked the agency to reimburse physicians for coordinating care for their chronically-ill patients. In a letter to administrator Donald Berwick, the Relative Value Scale Update Committee (better known as the RUC) recommended the Center for Medicare and Medicaid Services pay for phone calls, counseling sessions and other services that help their patients wend their way through the complicated health care system.”

The point of his article is where would the money come from to reimburse doctors.  However, that was not my issue.  I just don’t see doctors taking on this role.  Who exactly is the AMA referring to?  Where are these doctors who are valiantly leading patients through the trenches of the healthcare system?

Maybe the AMA is referring to the doctor’s office staff taking care of the coordination.  Most doctors don’t have the time to provide these services.  I have run across some concierge doctors who do their best to coordinate care.  After all, that is what a patient pays extra for.  Care coordination takes time and as a patient advocate, I know.  I do it all day long.  The most critical aspect is being accessible and available for support when needed.

I also think it doesn’t come naturally for the medical profession.  It is not part of the training.  It is more a part of a nurse practitioner’s training.  Is the AMA trying to usurp part of the NP role?  I guess when there is reimbursement involved anything is possible.  I have always believed the underlining issue of the AMA’s dislike for the NP role is the fear of loosing potential resources to another profession.

Bottom line for me is: if the AMA is going to get doctors reimbursement for care coordination, then I want it too!  Don’t make this into a new doctor role and claim it as your own.  There are qualified people doing this work.  Instead of adding more to the plate, use the resources that are available and successful.  Don’t reinvent the wheel.