Dr. Buddy Smith on ICD-10: “This should be a wake-up call … to be an advocate”

Medical Association President Buddy Smith, M.D., has had it with government mandates in medicine, likening ICD-10 to the proverbial “straw that broke the camel’s back.”

“It has gotten to the point of absurdity. We need more of the ‘practice’ of medicine and less of the ‘process’ of delivering medical care. We are forced to jump through hoops checking boxes that don’t do the first thing to improve patient care,” Dr. Smith said.

In his opinion, forced adoption of ICD-10 tops the list of practice aggravations and only adds to the frustrations an already overburdened physician workforce is having with their chosen profession.

Seeing the negative effect it would have on its members, over the past few years the Association worked with Congressman Gary Palmer (R-AL06) and the Alabama Delegation on legislation putting off ICD-10 adoption. The Association also worked with state media to raise awareness of the problems with ICD-10 and even the Legislature, ushering through a bipartisan resolution by Alabama’s two physician-Senators Tim Melson and Larry Stutts this spring urging Congress to either delay ICD-10 or find a way to offset the cost to medical practices. In the end, however, medicine was unfortunately unsuccessful, and the full effects will not be known for some time.

“We gave it our best, but with hospitals, insurance companies and the entire health care data and technology industry on the other side, the voices of physicians – like my dear friend the late Dr. Jeff Terry – were drowned out,” Dr. Smith said.

A silver lining, Dr. Smith says, was the Medical Association’s success in petitioning Blue Cross Blue Shield of Alabama and VIVA HEALTH along with Alabama Medicaid to implement “grace periods” for physician coding errors made under ICD-10 as is being allowed under Medicare Part B. Few other states have any commercial payors implementing any type of “grace period.”

“Most of our colleagues in other states will have zero leeway if they miscode for anyone other than a Medicare patient,” Dr. Smith said, “and even though we must still code under ICD-10 we are better off than most physicians in this country.”

In his rural Clay County medical practice, Dr. Smith tries to focus on the positive when there is bad news to deliver to patients. For physicians, ICD-10 implementation certainly fits that description. But there is hope, Dr. Smith believes, pointing to medicine’s successes on the state level as not only proof that doctors can be effective advocates for their patients and professions but also to using those successes as a blueprint for future battle plans.

“When you look at the multitude of proposed standards of care, trial lawyer tricks and threats to medicine our Medical Association and its members have fought off over the years, it’s truly remarkable,” he says. “We can succeed, but we all have to be in this together.”

Engaging more doctors and expanding the influence of organized medicine, he says, is the key to learning from the losses we’ve encountered while expanding on our successes. After losses on the Affordable Care Act and now ICD-10, while many in Washington are saying “organized medicine is dead” Dr. Smith believes the opposite is true. He thinks ICD-10 will instead be a turning point where physicians finally stand up and say enough is enough.

“This should be a wake-up call to my colleagues, not just in Alabama but around the nation, that non-physicians are dictating the future of our profession and you can’t afford not to be an advocate for the profession,” he said. “You are most vulnerable to giving up after you’ve suffered a loss – and ICD-10 was a loss for medicine – but we cannot abdicate the remainder of our profession without fighting every inch of the way.”