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re: Question for the OT nurses and docs - smoker?
Posted on 4/13/18 at 9:38 am to reveille
Posted on 4/13/18 at 9:38 am to reveille
Yep. It's a required question for meaningful use now. I can't even discharge a patient without answering it. The EMR won't let you. Funny thing is it's even infants. It asks about second hand smoke. Once they hit twelve it changes and asks if the 12 year old smokes. I think the youngest I have seen say yes is 15.
0
Posted on 4/13/18 at 9:41 am to windshieldman
Because dipping isn't bad for you
Posted on 4/13/18 at 10:13 am to reveille
quote:never was a smoker except for left handed roll your own while in Nam, however, my physical for employment with a major oil co (that Chevron bought) back in 1969 the Dr. asking me questions about my health had a Lucky Strike hanging out of his mouth. This was in Houma.
not a smoker but curious why it is that for every first visit for any doctor part of the questioning is always "are you a smoker, have you ever smoked". If you are in for a broken arm, what the hell difference does it make if the patient smokes? Does this change the way you treat or is it just to gather statistics??
Posted on 4/13/18 at 10:22 am to reveille
For Medicare and many if not all insurances, a doc spending a minute in any patient consultation for any random complaint asking about smoking habit is a separate billable treatment.
Posted on 4/13/18 at 10:31 am to reveille
The main reason for this is $$$. When electronic medical records(emrs) were newish, the government was giving a lot of money to doctors who used emrs if they proved meaningful use. One of the criteria to meet meaningful use was asking pertinent social history questions like tobacco and alcohol use.
Posted on 4/13/18 at 10:33 am to moshlux
quote:
the government was giving a lot of money to doctors who used emrs
The government was REIMBURSING a small portion of the expense associated with implementing EMR, if you met their measures.
Meaningful Use put many small practitioners out of business b/c EMR costs are f***ing expensive!
This post was edited on 4/13/18 at 10:35 am
Posted on 4/13/18 at 10:36 am to MSMHater
Not only is the question required for meaningful use, but also we (the clinic) are required to "close the loop" in a smoking cessation recommendation. If we do not document that we mentioned smoking cessation and gave a handout, none of it counts. I cant beg them for 10 minutes to stop, but if it's improperly documented--useless.
Eventually what CMS wants to accomplish is to decrease reimbursement if certain parameters are not met. In my opinion very few of these parameters do anything to improve patient care, but make a nightmare for our nurses and billers.
Eventually what CMS wants to accomplish is to decrease reimbursement if certain parameters are not met. In my opinion very few of these parameters do anything to improve patient care, but make a nightmare for our nurses and billers.
Posted on 4/13/18 at 10:44 am to moshlux
quote:
The main reason for this is $$$. When electronic medical records(emrs) were newish, the government was giving a lot of money to doctors who used emrs if they proved meaningful use. One of the criteria to meet meaningful use was asking pertinent social history questions like tobacco and alcohol use.
Almost. You got paid a certain "bonus" for meeting different levels of meaningful use. However, it was only a fraction of the cost to implement EMR, digital xray, etc in order to do so. If you did not do all of this, then you were penalized.
As far as when injuries are concerned, I ask because tobacco use can significantly lengthen the time needed for healing. It also can lead to non unions of fractures.
Posted on 4/13/18 at 10:50 am to TheFonz
I do believe that will happen in the future too
Posted on 4/13/18 at 11:10 am to TheFonz
The question that intrigues me is Are your parents still alive?
I always answer. Yes, through the miracle of modern medicine.
I always answer. Yes, through the miracle of modern medicine.
Posted on 4/13/18 at 11:17 am to el Gaucho
Ha. My dentist asked me if I was dipping. At the time I didn't dip but I was eating sunflower seeds like my life depended on it.
I dip on occasion (once a week or two) but I'm not admitting it on any medical forms. I know that stuff will come back to bite you at some point. And they don't differentiate between someone who uses irregularly and someone who is a can a day or more.
I dip on occasion (once a week or two) but I'm not admitting it on any medical forms. I know that stuff will come back to bite you at some point. And they don't differentiate between someone who uses irregularly and someone who is a can a day or more.
This post was edited on 4/13/18 at 11:18 am
Posted on 4/13/18 at 11:29 am to CaptainZappin
quote:
meaningful use
A very ironic term as the parameters which make it up are neither meaningful nor useful.
quote:
CMS wants to accomplish is to decrease reimbursement if certain parameters are not met.
Agree. The EMR incentives were a long con.
Posted on 4/13/18 at 11:32 am to TheFonz
quote:
Just wait until they start asking you if you have a gun in the house.
Pediatricians and some PCPs already do.
Posted on 4/13/18 at 11:36 am to reveille
First hooker: “Do you smoke after sex?”
Second hooker: “I don’t know—I never looked.”
Second hooker: “I don’t know—I never looked.”
Posted on 4/13/18 at 11:37 am to reveille
I remember I broke my wrist & went to after hours. I was in significant pain and was asked that question & I sorta got pissed and said "does it matter?" I actually did smoke at the time too ftr.
Posted on 4/13/18 at 11:51 am to rtbtiger
Thanks Hater and RTB. I knew there had to be a non medical reason for all that crap. Was in the hospital yesterday with a relative and nearly every person that came into the room asked the same damn questions. thanks OT...always a wealth of knowledge, with a side of sarcasm! 
Posted on 4/13/18 at 11:57 am to reveille
My step mom used to work for a doctor that would not write narcotics to smokers. He said they were more likely to abuse the drugs if they smoked. 
I have no idea if there is data to support his claim or not. Just always seemed a little ridiculous that he may possibly deny someone treatment even if they had never abused a drug because they smoked.
I have no idea if there is data to support his claim or not. Just always seemed a little ridiculous that he may possibly deny someone treatment even if they had never abused a drug because they smoked.
This post was edited on 4/13/18 at 11:57 am
Posted on 4/13/18 at 12:30 pm to reveille
To track statistics
To push smoking cessation products/programs
To report to insurance companies.
*Life insurance isn't cheap if they know you smoke and some won't pay out.
To push smoking cessation products/programs
To report to insurance companies.
*Life insurance isn't cheap if they know you smoke and some won't pay out.
Posted on 4/13/18 at 4:59 pm to reveille
quote:
If you are in for a broken arm, what the hell difference does it make if the patient smokes? Does this change the way you treat or is it just to gather statistics??
So we can point and laugh at trashy people...
Posted on 4/13/18 at 5:22 pm to WhiskeyThrottle
quote:
My dentist asked me if I was dipping. At the time I didn't dip but I was eating sunflower seeds like my life depended on it. I dip on occasion (once a week or two) but I'm not admitting it on any medical forms.
Not very smart imo. Your dentist is also looking out for your gum health. Knowing you dip is important information. Lying to your dentist/doctor/healthcare provider only hurts yourself in the long run,
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