The System Is Cruel
Ray S. Greco, MD
Private Practice Weirton, WVa
Arch Fam Med. 1994;3(8):655.
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The Editorial by Broadhead1 in the April 1994 issue of the ARCHIVES is indeed absolutely correct and timely. My objection is to his final conclusions of being honest and truthful in coding. I am still active after 45 years in family medicine. The basic bottom line by any good family physician is "do no harm." The two most frightening words to all of us are cancer and psychiatric. Say what you want—this is a human trait. Perhaps centuries down the road humankind will be different.
This past year I spent 45 minutes with a delightful woman who has been a patient of mine for at least 30 years and who had several situational problems. I coded the problems with a psychotherapy number. When she received the Medicare copy of her visit, the listing of a psychiatric diagnosis and treatment was devastating to an already hurting person.
The system is
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