As many of you who have attended the workshops know, Pamela Crouch, M.A., CCC-SLP is my partner in the Speech Team, and my best friend.  Her faith in our profession and in the care we provide to patients in crisis are real and enduring.  I hope her poem gives you strength in your life and profession as she has given to me.

As we have entered into the Medicare reform rollout period, which began last October 1, 2011, our lives are now characterized by increased stress due to company requested higher productivity levels, which in many cases will become a red flag to investigative teams seeking out fraud. Medical records of patients are now being copied for the RAC teams, and other investigative teams, and fines are being leveled because “perfection” is the rule of the law. Even we here at the Speech Team are altering our tests to include the patient’s name and date of evaluation on every single test page since RAC team reviewers require “absolute coherency” in every chart. The point being that a patient’s medical chart must read like a novel by non-medical accountants!  No more “off or low energy days” for any of us, even though we are human beings.

From all parts of this country of ours I hear the frustrations of chaos as the Medicare reforms are rolled out. Human oxidative stress levels are rising, company productivity levels are encouraging therapist fraud, and the patient is paying the freight with less patient care. The simple question is, “Can’t we ever transition change without chaos?” The answer is a resounding “No, because too many people believe in greed.” Not to be outdone on the bottom line profit margin, after an 11% cut in Medicare, the “healthcare business” is working the frontline professionals to unheard of stress levels, and then expecting perfection  in the  human endeavor of patient care.