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Wow, That was Fast

Well that sure didn’t take long…

In response to CMS Administrator Andy Slavitt’s comments last month regarding the future of the Meaningful Use Program and the need to recapture the hearts and minds of physicians I posted on open letter to Mr. Slavitt yesterday in an attempt to reach out to him regarding those issues.

I did not expect what happened next.

He answered within a couple of hours:

“Very thoughtful letter and I think likely reflects the views of many. I will share it internally because culturally people need to see the gulf between the policy ideas and the front line of medicine.

Believe all the fatigue and the laws we still need to implement and the current state of technology means it will take some time before differences are felt where they matter. Implementing laws like MACRA is a complex undertaking but the core of what you said I believe is the most important thing– It all begins with listening. The details matter here more than the principles but I’m a believer in that’s where it starts. And we have more focus groups and front line interactions than I have seen before. We are not just listening to “Washington” docs.

I try to always begin by calling it like we see it including hard truths. I believe we have work to do and want to orient people to the proper course. You always risk setting expectations when you lay out an agenda, particularly when there is no silver bullet. But it’s better than the alternative.”

Within moments I also received equally gracious responses from Patrick Conway and Kate Goodrich, also from CMS:

We both inherited the “meaningful use program” 6-12 months ago and do think the MACRA legislation providers an opportunity to transform the program, lessen burden, make much more simple, and flexible to meet docs needs. Happy to take ideas and input from you anytime and thanks for your work.”

Wow. You have to admit that this is not what one would expect from the “faceless, heartless bureaucrats” I have been criticizing in print and on Internet radio all this time. Is the paradigm changing? Maybe. Maybe not. But one thing is for sure – we physicians have to give them the chance to make good on their rhetoric. I certainly intend to to that.

Stay tuned….

February 19, 2016 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

An Open Letter to Andy Slavitt, Acting Administrator CMS

Mr. Andrew Slavitt
Acting Administrator
Centers for Medicare and Medicaid Services
Washington, D.C..

Dear Mr. Slavitt:

No doubt you were surprised at the strong, widespread reaction to your comments regarding the Meaningful Use Program as part of your speech to the JP Morgan Healthcare Conference several weeks ago. Your quote regarding the hearts and minds of physicians was particularly noteworthy. After decades of Federal regulatory hostility towards physicians, some of us doctors were pleasantly surprised – even shocked – to hear you acknowledge:

– physicians exist beyond just being another cog in the healthcare machine.
– physicians actually have hearts and minds.
– physicians’ opinions might have value to you.
– programs that are poorly designed distract physicians from patient care.
– CMS aspires to a “cultural focus on listening and learning”

Many of us physicians reacted like starving prisoners when the Commandant announces that there will be extra cockroaches for dinner. Though the news was small, many of us were overjoyed.

But most of us (60% by a recent survey) reacted differently. The majority of us understand the political savvy of saying something controversial about your enemy. Such a move can create a useful distraction, driving the enemy to argue amongst themselves while you continue with work that you would rather we didn’t notice…and that is exactly what has happened. Like an octopus squirting ink into the water you have created an effective smokescreen to let you spend the next few months coding Meaningful Use into MACRA without any interference from us.

So the purpose of this letter is to ask the question: Which of the above interpretations of your comments is correct? What are your intentions?

If your comments are sincere then consider this letter a warm introduction to the group of rapidly growing, grass-roots full time practicing physicians whom this letter represents. Over the past few years we have acquired the policy expertise and political skills to be effective leaders and collaborators with you to bring truly meaningful improvements to America’s health care. Realize that the leaders of organized medicine with whom you currently work – including the AMA , whose membership represents less than 15% of practicing physicians – do NOT represent the “hearts and minds” of physicians that you profess to seek. If you mean what you say then we are reaching out to you.

If, on the other hand, your comments are nothing more than political subterfuge, then this letter serves as a warning. We are not buying the political offal that you are selling. This physician group will use all of its intellectual, financial and political resources to make it far more difficult for you to destroy what is left of health care in America.

The choice is yours. We look forward to hearing from you.

Michael Koriwchak, M.D.
Vice President
Docs4PatientCare Foundation

February 18, 2016 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.